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: 94%
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
50,905
Total Claims
$4.2M
Drug Cost
856
Beneficiaries
$4,922
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+120%
Opioid rate vs peers
4.9% vs 2.2% avg
+249%
Cost per patient vs peers
$4,922 vs $1,411 avg
+68%
Brand preference vs peers
17.9% vs 10.6% 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.
Opioid Prescribing
4.9%
Opioid Rate
2,506
Opioid Claims
$88K
Opioid Cost
13.5%
Long-Acting Rate
Brand vs Generic
Brand: 9,066 claims · $2.9M
Generic: 41,582 claims · $1.3M
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 1,664 | $460K |
| Paliperidone Palmitate | 79 | $244K |
| Empagliflozin | 776 | $234K |
| Mirabegron | 815 | $183K |
| Dulaglutide | 165 | $144K |
| Valbenazine Tosylate | 29 | $135K |
| Rivaroxaban | 432 | $115K |
| Enzalutamide | 12 | $85K |
| Sitagliptin Phosphate | 268 | $83K |
| Insulin Glargine,hum.Rec.Anlog | 209 | $71K |
| Pimavanserin Tartrate | 26 | $60K |
| Glatiramer Acetate | 12 | $57K |
| Risperidone Microspheres | 30 | $54K |
| Tetrabenazine | 11 | $50K |
| Insulin Aspart | 122 | $49K |
Prescribing Profile
Patient Profile
76
Avg Age
65%
Female
2.42
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