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
5,229
Total Claims
$192K
Drug Cost
277
Beneficiaries
$693
Cost/Patient
Risk Score Breakdown 24/100
Score components are additive. Read full methodology
Peer Comparison vs. 3,186 Anesthesiology providers
+58%
Opioid rate vs peers
54.9% vs 34.8% avg
+64%
Cost per patient vs peers
$693 vs $422 avg
-74%
Brand preference vs peers
1.2% vs 4.7% 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.
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
54.9%
Opioid Rate
2,872
Opioid Claims
$144K
Opioid Cost
21.7%
Long-Acting Rate
This provider's opioid prescribing rate of 54.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 64 claims · $34K
Generic: 5,165 claims · $158K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 11 | $42K |
| Hydrocodone/Acetaminophen | 1,153 | $26K |
| Oxycodone Hcl | 12 | $18K |
| Oxycodone Hcl/Acetaminophen | 548 | $14K |
| Fentanyl | 76 | $12K |
| Gabapentin | 512 | $10K |
| Diclofenac Sodium | 432 | $8,758 |
| Morphine Sulfate | 248 | $7,844 |
| Pregabalin | 188 | $5,299 |
| Hydromorphone Hcl | 11 | $4,881 |
| Methadone Hcl | 257 | $4,704 |
| Oxycodone Hcl | 310 | $4,340 |
| Buprenorphine | 14 | $4,063 |
| Lidocaine | 83 | $3,159 |
| Naloxone Hcl | 35 | $3,132 |
Prescribing Profile
30
Unique Drugs
24.0
Anomaly Score
Patient Profile
67
Avg Age
53%
Female
1.72
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