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
546
Total Claims
$1.7M
Drug Cost
130
Beneficiaries
$13K
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 3,372 Medical Oncology providers
-6%
Opioid rate vs peers
5.5% vs 5.9% avg
+6%
Cost per patient vs peers
$13K vs $12K 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.
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
5.5%
Opioid Rate
30
Opioid Claims
$605
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 409 claims · $26K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Osimertinib Mesylate | 43 | $766K |
| Alectinib Hcl | 11 | $208K |
| Pazopanib Hcl | 14 | $177K |
| Apixaban | 11 | $6,807 |
| Erlotinib Hcl | 12 | $6,542 |
| Imatinib Mesylate | 11 | $1,262 |
| Prochlorperazine Maleate | 60 | $853 |
| Ondansetron Hcl | 58 | $590 |
| Dexamethasone | 68 | $537 |
| Potassium Chloride | 19 | $269 |
| Hydrocodone/Acetaminophen | 11 | $257 |
| Prednisone | 29 | $179 |
| Lorazepam | 21 | $93 |
| Azithromycin | 11 | $63 |
Prescribing Profile
Patient Profile
71
Avg Age
61%
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