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: 90%
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
814
Total Claims
$102K
Drug Cost
128
Beneficiaries
$797
Cost/Patient
Risk Score Breakdown 16/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+251%
Opioid rate vs peers
7.9% vs 2.2% avg
-43%
Cost per patient vs peers
$797 vs $1,411 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 90% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid rate is 251% 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
7.9%
Opioid Rate
64
Opioid Claims
$10K
Opioid Cost
35.9%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 658 claims · $16K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Tirzepatide | 13 | $16K |
| Albuterol Sulfate | 28 | $1,332 |
| Atorvastatin Calcium | 42 | $660 |
| Levothyroxine Sodium | 27 | $552 |
| Amlodipine Besylate | 27 | $433 |
| Lisinopril | 28 | $365 |
| Oxycodone Hcl | 25 | $338 |
| Bupropion Hcl | 16 | $332 |
| Tamsulosin Hcl | 16 | $301 |
| Gabapentin | 21 | $298 |
| Omeprazole | 18 | $221 |
| Famotidine | 13 | $215 |
| Diclofenac Sodium | 11 | $189 |
| Fluticasone Propionate | 14 | $187 |
| Fluoxetine Hcl | 13 | $173 |
Prescribing Profile
Patient Profile
69
Avg Age
48%
Female
1.78
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