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: 88%
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
2,860
Total Claims
$304K
Drug Cost
227
Beneficiaries
$1,340
Cost/Patient
Risk Score Breakdown 8/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
-84%
Opioid rate vs peers
1.5% vs 9.2% avg
+86%
Cost per patient vs peers
$1,340 vs $719 avg
+123%
Brand preference vs peers
14.8% vs 6.7% 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 88% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 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
1.5%
Opioid Rate
43
Opioid Claims
$183
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 418 claims · $256K
Generic: 2,402 claims · $46K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Semaglutide | 23 | $23K |
| Dulaglutide | 18 | $22K |
| Apixaban | 32 | $20K |
| Linaclotide | 35 | $20K |
| Cariprazine Hcl | 13 | $17K |
| Insulin Lispro | 20 | $16K |
| Budesonide/Formoterol Fumarate | 26 | $15K |
| Sitagliptin Phos/Metformin Hcl | 18 | $13K |
| Insulin Glargine,hum.Rec.Anlog | 28 | $13K |
| Insulin Aspart | 11 | $6,131 |
| Insulin Glargine,hum.Rec.Anlog | 12 | $5,401 |
| Albuterol Sulfate | 61 | $2,562 |
| Omeprazole | 112 | $1,786 |
| Gabapentin | 87 | $1,592 |
| Atorvastatin Calcium | 150 | $1,526 |
Prescribing Profile
Patient Profile
66
Avg Age
71%
Female
2.08
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.Methodology · About