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: 91%
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
25,367
Total Claims
$2.2M
Drug Cost
818
Beneficiaries
$2,720
Cost/Patient
Risk Score Breakdown 29/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+224%
Opioid rate vs peers
7.2% vs 2.2% avg
+93%
Cost per patient vs peers
$2,720 vs $1,411 avg
+30%
Brand preference vs peers
13.8% vs 10.6% 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.
Opioid rate is 224% above Internal Medicine peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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
7.2%
Opioid Rate
1,839
Opioid Claims
$72K
Opioid Cost
16.2%
Long-Acting Rate
Brand vs Generic
Brand: 3,492 claims · $1.7M
Generic: 21,773 claims · $563K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 568 | $219K |
| Dulaglutide | 140 | $160K |
| Deutetrabenazine | 11 | $125K |
| Rivaroxaban | 257 | $101K |
| Semaglutide | 55 | $55K |
| Empagliflozin | 34 | $49K |
| Linaclotide | 59 | $45K |
| Lipase/Protease/Amylase | 42 | $38K |
| Sacubitril/Valsartan | 71 | $36K |
| Insulin Lispro | 38 | $35K |
| Tirzepatide | 26 | $34K |
| Icosapent Ethyl | 62 | $31K |
| Rifaximin | 23 | $28K |
| Sitagliptin Phosphate | 48 | $27K |
| Budesonide/Formoterol Fumarate | 58 | $26K |
Prescribing Profile
Patient Profile
73
Avg Age
57%
Female
2.46
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