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: 88%
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
9,583
Total Claims
$1.5M
Drug Cost
428
Beneficiaries
$3,547
Cost/Patient
Risk Score Breakdown 23/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,743 Pediatric Medicine providers
+151%
Opioid rate vs peers
4.0% vs 1.6% avg
+69%
Cost per patient vs peers
$3,547 vs $2,098 avg
+33%
Brand preference vs peers
20.0% vs 15.1% 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
4.0%
Opioid Rate
382
Opioid Claims
$34K
Opioid Cost
17.0%
Long-Acting Rate
Brand vs Generic
Brand: 1,899 claims · $1.3M
Generic: 7,593 claims · $166K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Dulaglutide | 133 | $177K |
| Tirzepatide | 141 | $133K |
| Semaglutide | 101 | $129K |
| Empagliflozin | 81 | $100K |
| Semaglutide | 44 | $80K |
| Dapagliflozin Propanediol | 55 | $53K |
| Apixaban | 66 | $44K |
| Insulin Detemir | 53 | $43K |
| Mirabegron | 51 | $34K |
| Budesonide/Formoterol Fumarate | 58 | $34K |
| Sitagliptin Phosphate | 26 | $24K |
| Fluticasone/Umeclidin/Vilanter | 29 | $23K |
| Insulin Aspart | 25 | $23K |
| Insulin Glargine,hum.Rec.Anlog | 38 | $20K |
| Brexpiprazole | 12 | $20K |
Prescribing Profile
Patient Profile
66
Avg Age
61%
Female
1.64
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