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: 89%
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
7,125
Total Claims
$577K
Drug Cost
393
Beneficiaries
$1,469
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 3,186 Anesthesiology providers
+75%
Opioid rate vs peers
60.9% vs 34.8% avg
+248%
Cost per patient vs peers
$1,469 vs $422 avg
+33%
Brand preference vs peers
6.3% 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 89% 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
60.9%
Opioid Rate
4,336
Opioid Claims
$332K
Opioid Cost
26.8%
Long-Acting Rate
This provider's opioid prescribing rate of 60.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 448 claims · $316K
Generic: 6,677 claims · $262K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 97 | $84K |
| Hydrocodone/Acetaminophen | 1,519 | $72K |
| Onabotulinumtoxina | 39 | $62K |
| Ubrogepant | 20 | $43K |
| Dronabinol | 126 | $31K |
| Fentanyl | 285 | $27K |
| Erenumab-Aooe | 21 | $22K |
| Morphine Sulfate | 522 | $22K |
| Buprenorphine Hcl | 18 | $19K |
| Oxycodone Hcl | 28 | $19K |
| Oxycodone Hcl | 492 | $14K |
| Oxycodone Hcl/Acetaminophen | 318 | $14K |
| Buprenorphine | 32 | $14K |
| Hydromorphone Hcl | 369 | $10K |
| Gabapentin | 383 | $7,928 |
Prescribing Profile
55
Unique Drugs
21.0
Anomaly Score
Patient Profile
67
Avg Age
61%
Female
1.64
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