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
1,206
Total Claims
$52K
Drug Cost
254
Beneficiaries
$206
Cost/Patient
Risk Score Breakdown 8/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
-19%
Opioid rate vs peers
3.1% vs 3.8% avg
-82%
Cost per patient vs peers
$206 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.
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
3.1%
Opioid Rate
37
Opioid Claims
$223
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 1,075 claims · $20K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Tiotropium Bromide | 11 | $5,322 |
| Olmesartan Medoxomil | 12 | $4,396 |
| Atorvastatin Calcium | 59 | $1,352 |
| Rosuvastatin Calcium | 17 | $1,017 |
| Levothyroxine Sodium | 11 | $930 |
| Metoprolol Succinate | 32 | $922 |
| Lisinopril | 79 | $901 |
| Albuterol Sulfate | 31 | $896 |
| Levothyroxine Sodium | 32 | $815 |
| Ezetimibe | 13 | $708 |
| Gabapentin | 39 | $683 |
| Simvastatin | 60 | $544 |
| Omeprazole | 13 | $482 |
| Baclofen | 13 | $445 |
| Venlafaxine Hcl | 15 | $412 |
Prescribing Profile
33
Unique Drugs
8.0
Anomaly Score
Patient Profile
69
Avg Age
76%
Female
0.92
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