⚠️

Risk scores are statistical indicators based on prescribing patterns compared to specialty peers. They are NOT allegations of fraud, misconduct, or improper care. Many legitimate medical reasons can explain outlier prescribing.

Read our methodology →

Carlos CandalesARNP

Nurse Practitioner · Miami, FL 33183

NPI: 1134576465

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18

🟡 Moderate

ML Fraud Detection Score: 88%

Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.

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Risk Flags

Elevated antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberHigh fills per patient

Risk indicators are statistical patterns, not allegations. Learn more

15,493

Total Claims

$680K

Drug Cost

636

Beneficiaries

$1,069

Cost/Patient

Risk Score Breakdown 18/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid + benzodiazepine combo+8
Elderly antipsychotic prescribing+5
High fills per patient+3

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

-92%

Opioid rate vs peers

0.3% vs 3.8% avg

-9%

Cost per patient vs peers

$1,069 vs $1,174 avg

-1%

Brand preference vs peers

8.8% vs 8.9% avg

⚠️ Opioid + Benzodiazepine Co-Prescriber

This provider prescribes both opioids and benzodiazepines. The FDA has issued a Black Box Warning about the life-threatening risks of concurrent use.

🔎 Data Overview

🤖

ML fraud detection score of 88% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.

⚠️

This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.

Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.

Opioid Prescribing

0.3%

Opioid Rate

49

Opioid Claims

$214

Opioid Cost

Long-Acting Rate

Brand vs Generic

91% generic

Brand: 1,346 claims · $449K

Generic: 13,961 claims · $226K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban205$107K
Rifaximin12$36K
Sacubitril/Valsartan38$24K
Insulin Glargine,hum.Rec.Anlog53$22K
Insulin Glargine,hum.Rec.Anlog37$19K
Rivaroxaban33$18K
Insulin Aspart80$18K
Budesonide/Formoterol Fumarate70$16K
Sitagliptin Phosphate25$13K
Ticagrelor30$13K
Insulin Aspart Prot/Insuln Asp39$12K
Esomeprazole Magnesium171$11K
Tiotropium Bromide20$9,816
Fluticasone/Vilanterol25$9,433
Levothyroxine Sodium239$9,300

Prescribing Profile

172

Unique Drugs

$181K

IRA Negotiated Drugs

18.0

Anomaly Score

Patient Profile

76

Avg Age

58%

Female

2.20

Avg Risk Score

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Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations of wrongdoing.Methodology · About · Dispute this data