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: 92%
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
417
Total Claims
$17K
Drug Cost
108
Beneficiaries
$154
Cost/Patient
Risk Score Breakdown 19/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+382%
Opioid rate vs peers
18.2% vs 3.8% avg
-87%
Cost per patient vs peers
$154 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
ML fraud detection score of 92% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid rate is 382% above Nurse Practitioner peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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.
Prescribes only 10 unique drugs, which is unusually low. Most providers prescribe 30+ different medications. Narrow prescribing patterns deserve context about the provider's practice scope.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
18.2%
Opioid Rate
76
Opioid Claims
$4,834
Opioid Cost
21.1%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 381 claims · $9,122
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Tramadol Hcl | 23 | $1,276 |
| Fentanyl | 11 | $957 |
| Oxycodone Hcl | 22 | $651 |
| Mirtazapine | 27 | $647 |
| Nystatin | 13 | $392 |
| Sertraline Hcl | 33 | $347 |
| Alprazolam | 33 | $282 |
| Quetiapine Fumarate | 12 | $267 |
| Lorazepam | 17 | $221 |
| Ciprofloxacin Hcl | 12 | $100 |
Prescribing Profile
10
Unique Drugs
19.0
Anomaly Score
Patient Profile
84
Avg Age
66%
Female
2.86
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