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
1,455
Total Claims
$3.1M
Drug Cost
209
Beneficiaries
$15K
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 8,541 Hematology-Oncology providers
+75%
Opioid rate vs peers
11.0% vs 6.3% avg
+8%
Cost per patient vs peers
$15K vs $14K 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
11.0%
Opioid Rate
160
Opioid Claims
$11K
Opioid Cost
20.0%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 1,217 claims · $744K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Enzalutamide | 63 | $706K |
| Axitinib | 28 | $582K |
| Abiraterone Acetate | 197 | $572K |
| Cabozantinib S-Malate | 19 | $508K |
| Everolimus | 13 | $154K |
| Apixaban | 35 | $24K |
| Lipase/Protease/Amylase | 16 | $9,422 |
| Oxycodone Hcl | 73 | $1,699 |
| Prednisone | 213 | $1,224 |
| Ondansetron Hcl | 75 | $1,204 |
| Prochlorperazine Maleate | 55 | $1,097 |
| Oxycodone Hcl/Acetaminophen | 15 | $883 |
| Diphenoxylate Hcl/Atropine | 35 | $656 |
| Gabapentin | 48 | $480 |
| Tamsulosin Hcl | 25 | $462 |
Prescribing Profile
Patient Profile
72
Avg Age
27%
Female
2.54
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