⚠️

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 →

Carlos ElizondoM.D.

Family Practice · Alice, TX 78332

NPI: 1417391764

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21

🟡 Moderate

ML Fraud Detection Score: 84%

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-prescriber

Risk indicators are statistical patterns, not allegations. Learn more

30,969

Total Claims

$3.8M

Drug Cost

1,811

Beneficiaries

$2,077

Cost/Patient

Risk Score Breakdown 21/100

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

Score components are additive. Read full methodology

Peer Comparison vs. 106,889 Family Practice providers

+78%

Opioid rate vs peers

4.6% vs 2.6% avg

+95%

Cost per patient vs peers

$2,077 vs $1,068 avg

+62%

Brand preference vs peers

14.6% 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 84% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 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

4.6%

Opioid Rate

1,423

Opioid Claims

$37K

Opioid Cost

0.9%

Long-Acting Rate

Brand vs Generic

85% generic

Brand: 4,467 claims · $3.2M

Generic: 26,181 claims · $550K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Semaglutide320$351K
Dulaglutide246$311K
Semaglutide212$282K
Apixaban335$169K
Empagliflozin229$169K
Tirzepatide125$141K
Denosumab72$122K
Dapagliflozin Propanediol129$113K
Sitagliptin Phosphate107$102K
Linaclotide115$85K
Mirabegron98$66K
Fluticasone/Umeclidin/Vilanter68$55K
Dapaglifloz Propaned/Metformin60$51K
Insulin Glargine,hum.Rec.Anlog46$47K
Rivaroxaban56$43K

Prescribing Profile

229

Unique Drugs

$673K

IRA Negotiated Drugs

$1.1M

GLP-1 Drugs

21.0

Anomaly Score

Patient Profile

72

Avg Age

58%

Female

1.75

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