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: 88%
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
20,922
Total Claims
$641K
Drug Cost
555
Beneficiaries
$1,155
Cost/Patient
Risk Score Breakdown 26/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,389 General Practice providers
-87%
Opioid rate vs peers
0.3% vs 2.5% avg
+2%
Cost per patient vs peers
$1,155 vs $1,128 avg
-34%
Brand preference vs peers
5.6% vs 8.4% 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
67
Opioid Claims
$1,143
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 1,153 claims · $394K
Generic: 19,610 claims · $241K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 151 | $85K |
| Rivaroxaban | 99 | $53K |
| Insulin Glargine,hum.Rec.Anlog | 102 | $43K |
| Sitagliptin Phos/Metformin Hcl | 49 | $28K |
| Sitagliptin Phosphate | 44 | $28K |
| Insulin Lispro | 72 | $27K |
| Dapagliflozin Propanediol | 30 | $16K |
| Rivastigmine | 97 | $15K |
| Levothyroxine Sodium | 1,062 | $15K |
| Atorvastatin Calcium | 1,697 | $14K |
| Memantine Hcl | 97 | $9,439 |
| Insulin Nph Hum/Reg Insulin Hm | 39 | $8,681 |
| Empagliflozin | 16 | $8,565 |
| Memantine Hcl | 556 | $8,379 |
| Linagliptin | 12 | $8,308 |
Prescribing Profile
Patient Profile
78
Avg Age
60%
Female
3.06
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