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: 90%
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
9,563
Total Claims
$670K
Drug Cost
475
Beneficiaries
$1,410
Cost/Patient
Risk Score Breakdown 39/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+756%
Opioid rate vs peers
32.4% vs 3.8% avg
+20%
Cost per patient vs peers
$1,410 vs $1,174 avg
-10%
Brand preference vs peers
8.0% vs 8.9% 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 90% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 756% above the average for Nurse Practitioner 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
32.4%
Opioid Rate
3,097
Opioid Claims
$326K
Opioid Cost
28.7%
Long-Acting Rate
This provider's opioid prescribing rate of 32.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 764 claims · $388K
Generic: 8,783 claims · $282K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 164 | $83K |
| Oxycodone Hcl/Acetaminophen | 433 | $78K |
| Oxycodone Hcl | 31 | $36K |
| Oxycodone Hcl | 1,115 | $34K |
| Methylnaltrexone Bromide | 13 | $32K |
| Rimegepant Sulfate | 18 | $30K |
| Naloxegol Oxalate | 40 | $17K |
| Semaglutide | 14 | $14K |
| Buprenorphine Hcl | 26 | $14K |
| Hydrocodone/Acetaminophen | 442 | $12K |
| Morphine Sulfate | 620 | $12K |
| Erenumab-Aooe | 14 | $11K |
| Gabapentin | 596 | $7,673 |
| Linaclotide | 12 | $7,593 |
| Tizanidine Hcl | 664 | $6,982 |
Prescribing Profile
Patient Profile
65
Avg Age
59%
Female
1.68
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