⚠️

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 →

James WheelerM.D.

Family Practice · Louisville, KY 40299

NPI: 1275537094

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24

🟡 Moderate

ML Fraud Detection Score: 91%

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

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

Risk indicators are statistical patterns, not allegations. Learn more

24,931

Total Claims

$2.1M

Drug Cost

1,071

Beneficiaries

$1,967

Cost/Patient

Risk Score Breakdown 24/100

Low (0)Moderate (15)Elevated (30)High (50+)
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8
High fills per patient+3

Score components are additive. Read full methodology

Peer Comparison vs. 106,889 Family Practice providers

-56%

Opioid rate vs peers

1.1% vs 2.6% avg

+84%

Cost per patient vs peers

$1,967 vs $1,068 avg

+10%

Brand preference vs peers

9.9% vs 9.0% 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 91% 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

1.1%

Opioid Rate

283

Opioid Claims

$3,110

Opioid Cost

Long-Acting Rate

Brand vs Generic

90% generic

Brand: 2,466 claims · $1.4M

Generic: 22,346 claims · $672K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Apixaban255$175K
Valbenazine Tosylate11$93K
Adalimumab12$89K
Empagliflozin83$87K
Eslicarbazepine Acetate70$77K
Semaglutide43$62K
Linaclotide107$61K
Rivaroxaban62$54K
Iloperidone13$48K
Sitagliptin Phosphate49$45K
Chlorpromazine Hcl112$40K
Cannabidiol (Cbd)24$40K
Dapagliflozin Propanediol26$39K
Insulin Glargine,hum.Rec.Anlog26$33K
Denosumab19$32K

Prescribing Profile

249

Unique Drugs

$406K

IRA Negotiated Drugs

$99K

GLP-1 Drugs

24.0

Anomaly Score

Patient Profile

73

Avg Age

53%

Female

1.04

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