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: 84%
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
1,827
Total Claims
$117K
Drug Cost
342
Beneficiaries
$341
Cost/Patient
Risk Score Breakdown 13/100
Score components are additive. Read full methodology
Peer Comparison vs. 16,767 Hospitalist providers
+123%
Opioid rate vs peers
6.7% vs 3.0% avg
-20%
Cost per patient vs peers
$341 vs $427 avg
+31%
Brand preference vs peers
6.9% vs 5.2% 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 84% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 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
6.7%
Opioid Rate
122
Opioid Claims
$7,015
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 124 claims · $91K
Generic: 1,683 claims · $24K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Semaglutide | 11 | $11K |
| Atorvastatin Calcium | 66 | $1,200 |
| Levothyroxine Sodium | 57 | $986 |
| Gabapentin | 52 | $670 |
| Amlodipine Besylate | 49 | $643 |
| Mirtazapine | 12 | $607 |
| Hydrocodone/Acetaminophen | 50 | $590 |
| Trazodone Hcl | 21 | $433 |
| Metoprolol Succinate | 30 | $361 |
| Losartan Potassium | 27 | $359 |
| Furosemide | 70 | $355 |
| Sertraline Hcl | 28 | $348 |
| Pantoprazole Sodium | 29 | $339 |
| Amoxicillin/Potassium Clav | 33 | $329 |
| Metformin Hcl | 16 | $326 |
Prescribing Profile
Patient Profile
76
Avg Age
57%
Female
2.81
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