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: 93%
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
505
Total Claims
$74K
Drug Cost
177
Beneficiaries
$416
Cost/Patient
Risk Score Breakdown 8/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,716 Vascular Surgery providers
+55%
Opioid rate vs peers
17.6% vs 11.4% avg
-3%
Cost per patient vs peers
$416 vs $430 avg
+10%
Brand preference vs peers
16.8% vs 15.2% 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 93% indicates prescribing patterns with significant similarity to confirmed fraud cases. 19 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
17.6%
Opioid Rate
89
Opioid Claims
$955
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 85 claims · $66K
Generic: 420 claims · $8,027
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 43 | $36K |
| Rivaroxaban | 29 | $21K |
| Ticagrelor | 13 | $9,099 |
| Clopidogrel Bisulfate | 108 | $4,319 |
| Cilostazol | 35 | $1,103 |
| Hydrocodone/Acetaminophen | 60 | $591 |
| Gabapentin | 31 | $388 |
| Tramadol Hcl | 21 | $206 |
| Cephalexin | 70 | $107 |
| Minocycline Hcl | 12 | $93 |
| Diazepam | 48 | $56 |
Prescribing Profile
Patient Profile
71
Avg Age
50%
Female
2.37
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