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: 94%
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
1,976
Total Claims
$433K
Drug Cost
313
Beneficiaries
$1,382
Cost/Patient
Risk Score Breakdown 16/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
-75%
Opioid rate vs peers
2.3% vs 9.2% avg
+92%
Cost per patient vs peers
$1,382 vs $719 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 94% 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
2.3%
Opioid Rate
46
Opioid Claims
$656
Opioid Cost
37.0%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 1,790 claims · $62K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Rotigotine | 33 | $40K |
| Rimegepant Sulfate | 12 | $18K |
| Suvorexant | 14 | $6,362 |
| Gabapentin | 349 | $4,456 |
| Ropinirole Hcl | 111 | $4,334 |
| Mirtazapine | 82 | $3,780 |
| Pramipexole Di-Hcl | 179 | $3,626 |
| Ropinirole Hcl | 19 | $3,248 |
| Armodafinil | 56 | $3,098 |
| Doxepin Hcl | 19 | $3,052 |
| Dextroamphetamine/Amphetamine | 22 | $1,567 |
| Levetiracetam | 46 | $1,475 |
| Modafinil | 36 | $1,396 |
| Pregabalin | 26 | $1,200 |
| Clonazepam | 134 | $953 |
Prescribing Profile
35
Unique Drugs
16.0
Anomaly Score
Patient Profile
70
Avg Age
50%
Female
1.15
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