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: 93%
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
14,171
Total Claims
$794K
Drug Cost
696
Beneficiaries
$1,140
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
-88%
Opioid rate vs peers
1.1% vs 9.2% avg
+59%
Cost per patient vs peers
$1,140 vs $719 avg
+10%
Brand preference vs peers
7.3% vs 6.7% 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 93% indicates prescribing patterns with significant similarity to confirmed fraud cases. 19 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
1.1%
Opioid Rate
155
Opioid Claims
$5,957
Opioid Cost
19.4%
Long-Acting Rate
Brand vs Generic
Brand: 1,024 claims · $441K
Generic: 13,016 claims · $349K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 160 | $88K |
| Rivaroxaban | 70 | $37K |
| Rifaximin | 12 | $36K |
| Tiotropium Bromide | 43 | $29K |
| Aripiprazole | 141 | $26K |
| Tiotropium Bromide | 42 | $23K |
| Insulin Glargine,hum.Rec.Anlog | 41 | $19K |
| Insulin Aspart | 36 | $18K |
| Quetiapine Fumarate | 798 | $18K |
| Budesonide/Formoterol Fumarate | 45 | $17K |
| Atorvastatin Calcium | 846 | $13K |
| Mirabegron | 29 | $13K |
| Memantine Hcl | 180 | $12K |
| Paliperidone | 31 | $12K |
| Umeclidinium Bromide | 27 | $9,955 |
Prescribing Profile
Patient Profile
75
Avg Age
56%
Female
2.19
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