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: 88%
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
12,507
Total Claims
$3.0M
Drug Cost
506
Beneficiaries
$5,912
Cost/Patient
Risk Score Breakdown 40/100
Score components are additive. Read full methodology
Peer Comparison vs. 17,619 Orthopedic Surgery providers
+46%
Opioid rate vs peers
45.2% vs 31.0% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ 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.
Opioid Prescribing
45.2%
Opioid Rate
5,659
Opioid Claims
$2.4M
Opioid Cost
29.8%
Long-Acting Rate
This provider's opioid prescribing rate of 45.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 11,456 claims · $2.0M
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 1,997 | $1.7M |
| Methylnaltrexone Bromide | 84 | $206K |
| Oxycodone Myristate | 233 | $175K |
| Buprenorphine Hcl | 187 | $162K |
| Oxycodone Hcl | 131 | $90K |
| Oxycodone Hcl/Acetaminophen | 26 | $78K |
| Rimegepant Sulfate | 36 | $75K |
| Ubrogepant | 19 | $45K |
| Hydrocodone/Acetaminophen | 1,463 | $28K |
| Lidocaine | 72 | $26K |
| Nabumetone | 16 | $26K |
| Fentanyl | 232 | $25K |
| Tramadol Hcl | 364 | $24K |
| Naloxegol Oxalate | 41 | $19K |
| Tapentadol Hcl | 13 | $18K |
Prescribing Profile
67
Unique Drugs
40.0
Anomaly Score
Patient Profile
66
Avg Age
54%
Female
1.69
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