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: 84%
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
3,582
Total Claims
$118K
Drug Cost
446
Beneficiaries
$265
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1645%
Opioid rate vs peers
66.0% vs 3.8% avg
-77%
Cost per patient vs peers
$265 vs $1,174 avg
-79%
Brand preference vs peers
1.9% vs 8.9% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
ML fraud detection score of 84% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 1,645% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
66.0%
Opioid Rate
2,364
Opioid Claims
$75K
Opioid Cost
2.9%
Long-Acting Rate
This provider's opioid prescribing rate of 66.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 67 claims · $31K
Generic: 3,515 claims · $87K
Patient Profile
63
Avg Age
68%
Female
1.85
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