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: 85%
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
35,958
Total Claims
$5.8M
Drug Cost
2,197
Beneficiaries
$2,653
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,194 Neurology providers
+39%
Opioid rate vs peers
1.8% vs 1.3% avg
-34%
Cost per patient vs peers
$2,653 vs $4,034 avg
-6%
Brand preference vs peers
8.8% vs 9.4% 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 85% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 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
1.8%
Opioid Rate
653
Opioid Claims
$18K
Opioid Cost
7.2%
Long-Acting Rate
Brand vs Generic
Brand: 3,174 claims · $4.2M
Generic: 32,747 claims · $1.6M
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Diclofenac Sodium | 4,196 | $1.3M |
| Rimegepant Sulfate | 488 | $784K |
| Ubrogepant | 223 | $303K |
| Interferon Beta-1a/Albumin | 22 | $239K |
| Immun Glob G(Igg)/Gly/Iga Ov50 | 11 | $183K |
| Lidocaine | 782 | $173K |
| Erenumab-Aooe | 172 | $152K |
| Linaclotide | 256 | $149K |
| Memantine Hcl | 864 | $122K |
| Doxepin Hcl | 319 | $109K |
| Diclofenac Sodium | 27 | $106K |
| Cariprazine Hcl | 57 | $98K |
| Brexpiprazole | 56 | $88K |
| Dextromethorphan Hbr/Quinidine | 48 | $77K |
| Naloxegol Oxalate | 173 | $76K |
Prescribing Profile
134
Unique Drugs
21.0
Anomaly Score
Patient Profile
72
Avg Age
73%
Female
1.42
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