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: Very High
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
2,849
Total Claims
$253K
Drug Cost
312
Beneficiaries
$811
Cost/Patient
Risk Score Breakdown 8/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+303%
Opioid rate vs peers
15.2% vs 3.8% avg
-31%
Cost per patient vs peers
$811 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 rate is 303% 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.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
15.2%
Opioid Rate
434
Opioid Claims
$15K
Opioid Cost
2.8%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 2,494 claims · $54K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Semaglutide | 32 | $31K |
| Empagliflozin | 43 | $28K |
| Brexpiprazole | 14 | $22K |
| Dulaglutide | 15 | $15K |
| Fluticasone/Umeclidin/Vilanter | 21 | $15K |
| Insulin Aspart Prot/Insuln Asp | 14 | $10K |
| Hydrocodone/Acetaminophen | 202 | $5,321 |
| Oxycodone Hcl/Acetaminophen | 61 | $2,826 |
| Testosterone | 12 | $2,678 |
| Dantrolene Sodium | 13 | $2,426 |
| Pregabalin | 46 | $2,306 |
| Rosuvastatin Calcium | 45 | $1,895 |
| Alprazolam | 226 | $1,559 |
| Albuterol Sulfate | 35 | $1,536 |
| Gabapentin | 78 | $1,509 |
Prescribing Profile
Patient Profile
70
Avg Age
60%
Female
1.28
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