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: 91%
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
20,307
Total Claims
$1.7M
Drug Cost
1,124
Beneficiaries
$1,479
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,195 Dermatology providers
+519%
Opioid rate vs peers
3.9% vs 0.6% avg
+22%
Cost per patient vs peers
$1,479 vs $1,209 avg
+154%
Brand preference vs peers
19.0% vs 7.5% 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 91% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 519% above the average for Dermatology providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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
3.9%
Opioid Rate
801
Opioid Claims
$19K
Opioid Cost
11.1%
Long-Acting Rate
Brand vs Generic
Brand: 3,849 claims · $1.1M
Generic: 16,400 claims · $559K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 689 | $181K |
| Adalimumab | 13 | $100K |
| Rivaroxaban | 209 | $52K |
| Rifaximin | 25 | $51K |
| Empagliflozin | 159 | $47K |
| Insulin Glargine,hum.Rec.Anlog | 110 | $36K |
| Insulin Glargine,hum.Rec.Anlog | 275 | $29K |
| Sacubitril/Valsartan | 61 | $20K |
| Dapagliflozin Propanediol | 74 | $20K |
| Dimethyl Fumarate | 12 | $19K |
| Insulin Glargine,hum.Rec.Anlog | 84 | $16K |
| Atorvastatin Calcium | 948 | $15K |
| Insulin Aspart | 61 | $15K |
| Budesonide/Formoterol Fumarate | 41 | $15K |
| Ipratropium/Albuterol Sulfate | 28 | $14K |
Prescribing Profile
Patient Profile
75
Avg Age
57%
Female
2.77
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