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 →ML Fraud Detection Score: 94%
Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
4,964
Total Claims
$346K
Drug Cost
346
Beneficiaries
$1,000
Cost/Patient
Risk Score Breakdown 29/100
Score components are additive. Read full methodology
Peer Comparison vs. 3,186 Anesthesiology providers
+63%
Opioid rate vs peers
56.5% vs 34.8% avg
+137%
Cost per patient vs peers
$1,000 vs $422 avg
+3%
Brand preference vs peers
4.9% vs 4.7% 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 94% indicates prescribing patterns with significant similarity to confirmed fraud cases. 19 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
56.5%
Opioid Rate
2,807
Opioid Claims
$261K
Opioid Cost
38.5%
Long-Acting Rate
This provider's opioid prescribing rate of 56.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 243 claims · $191K
Generic: 4,721 claims · $155K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 97 | $113K |
| Fentanyl | 390 | $54K |
| Oxycodone Hcl | 15 | $21K |
| Morphine Sulfate | 507 | $18K |
| Linaclotide | 26 | $16K |
| Hydrocodone/Acetaminophen | 667 | $14K |
| Hydrocodone Bitartrate | 13 | $13K |
| Oxycodone Hcl | 466 | $9,622 |
| Oxycodone Hcl/Acetaminophen | 330 | $9,352 |
| Gabapentin | 475 | $9,302 |
| Celecoxib | 78 | $5,360 |
| Tizanidine Hcl | 233 | $3,676 |
| Tramadol Hcl | 32 | $3,177 |
| Pregabalin | 147 | $2,760 |
| Duloxetine Hcl | 134 | $2,648 |
Prescribing Profile
38
Unique Drugs
29.0
Anomaly Score
Patient Profile
72
Avg Age
55%
Female
1.21
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