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: 95%
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
1,003
Total Claims
$45K
Drug Cost
157
Beneficiaries
$287
Cost/Patient
Risk Score Breakdown 47/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+1899%
Opioid rate vs peers
51.5% vs 2.6% avg
-73%
Cost per patient vs peers
$287 vs $1,068 avg
-20%
Brand preference vs peers
7.2% vs 9.0% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ 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
51.5%
Opioid Rate
517
Opioid Claims
$21K
Opioid Cost
23.4%
Long-Acting Rate
This provider's opioid prescribing rate of 51.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 72 claims · $16K
Generic: 931 claims · $29K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Dronabinol | 34 | $8,349 |
| Oxycodone Hcl | 196 | $7,186 |
| Naloxegol Oxalate | 12 | $5,211 |
| Hydrocodone/Acetaminophen | 107 | $3,647 |
| Fentanyl | 34 | $2,962 |
| Naloxone Hcl | 27 | $2,265 |
| Oxycodone Hcl/Acetaminophen | 41 | $1,548 |
| Gabapentin | 83 | $1,138 |
| Morphine Sulfate | 53 | $974 |
| Duloxetine Hcl | 89 | $908 |
| Morphine Sulfate | 24 | $880 |
| Methadone Hcl | 28 | $750 |
| Hydromorphone Hcl | 22 | $649 |
| Pregabalin | 34 | $417 |
| Famotidine | 15 | $165 |
Prescribing Profile
17
Unique Drugs
47.0
Anomaly Score
Patient Profile
70
Avg Age
55%
Female
3.00
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