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
1,964
Total Claims
$117K
Drug Cost
292
Beneficiaries
$402
Cost/Patient
Risk Score Breakdown 18/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,621 Pain Management providers
+53%
Opioid rate vs peers
63.2% vs 41.3% avg
+1%
Cost per patient vs peers
$402 vs $399 avg
+14%
Brand preference vs peers
4.3% vs 3.8% 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.
Opioid Prescribing
63.2%
Opioid Rate
1,242
Opioid Claims
$89K
Opioid Cost
9.2%
Long-Acting Rate
This provider's opioid prescribing rate of 63.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 84 claims · $59K
Generic: 1,880 claims · $58K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Tapentadol Hcl | 20 | $34K |
| Buprenorphine Hcl | 15 | $13K |
| Oxycodone Hcl | 351 | $11K |
| Buprenorphine | 19 | $6,560 |
| Oxycodone Hcl/Acetaminophen | 276 | $6,419 |
| Hydrocodone/Acetaminophen | 242 | $5,118 |
| Buprenorphine Hcl/Naloxone Hcl | 12 | $3,690 |
| Lidocaine | 33 | $3,489 |
| Gabapentin | 180 | $1,807 |
| Tramadol Hcl | 15 | $1,372 |
| Hydromorphone Hcl | 24 | $1,328 |
| Morphine Sulfate | 17 | $1,286 |
| Celecoxib | 18 | $1,203 |
| Tizanidine Hcl | 83 | $1,137 |
| Pregabalin | 55 | $1,125 |
Prescribing Profile
27
Unique Drugs
18.0
Anomaly Score
Patient Profile
69
Avg Age
62%
Female
1.59
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About