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: 97%
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
3,010
Total Claims
$245K
Drug Cost
341
Beneficiaries
$717
Cost/Patient
Risk Score Breakdown 23/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+691%
Opioid rate vs peers
29.9% vs 3.8% avg
-39%
Cost per patient vs peers
$717 vs $1,174 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
Our machine learning model — trained on 281 confirmed fraud cases — gives this provider a "Very High" fraud-pattern score. All 20 decision trees in our ensemble model agree that this provider's prescribing patterns resemble those of confirmed fraud cases. This is a statistical finding, not an accusation.
Opioid prescribing rate is 691% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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
29.9%
Opioid Rate
901
Opioid Claims
$74K
Opioid Cost
19.1%
Long-Acting Rate
This provider's opioid prescribing rate of 29.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 2,746 claims · $87K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 30 | $21K |
| Oxycodone Hcl/Acetaminophen | 458 | $20K |
| Semaglutide | 15 | $17K |
| Buprenorphine Hcl/Naloxone Hcl | 90 | $17K |
| Buprenorphine Hcl/Naloxone Hcl | 29 | $16K |
| Oxycodone Myristate | 13 | $13K |
| Buprenorphine Hcl/Naloxone Hcl | 11 | $11K |
| Naloxegol Oxalate | 18 | $7,325 |
| Hydrocodone/Acetaminophen | 152 | $5,451 |
| Gabapentin | 222 | $4,067 |
| Pregabalin | 77 | $3,350 |
| Morphine Sulfate | 72 | $2,764 |
| Buprenorphine Hcl | 43 | $2,685 |
| Duloxetine Hcl | 67 | $2,343 |
| Celecoxib | 46 | $1,549 |
Prescribing Profile
Patient Profile
68
Avg Age
58%
Female
1.37
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