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
17,883
Total Claims
$1.2M
Drug Cost
657
Beneficiaries
$1,839
Cost/Patient
Risk Score Breakdown 62/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1202%
Opioid rate vs peers
29.2% vs 2.2% avg
+30%
Cost per patient vs peers
$1,839 vs $1,411 avg
-46%
Brand preference vs peers
5.7% vs 10.6% 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
29.2%
Opioid Rate
5,213
Opioid Claims
$306K
Opioid Cost
22.4%
Long-Acting Rate
This provider's opioid prescribing rate of 29.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,018 claims · $724K
Generic: 16,865 claims · $485K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Ubrogepant | 94 | $154K |
| Oxycodone Hcl/Acetaminophen | 2,434 | $82K |
| Methylnaltrexone Bromide | 16 | $77K |
| Pregabalin | 1,226 | $72K |
| Rimegepant Sulfate | 33 | $54K |
| Lidocaine | 93 | $54K |
| Linaclotide | 80 | $53K |
| Buprenorphine | 205 | $46K |
| Erenumab-Aooe | 59 | $45K |
| Atogepant | 31 | $36K |
| Naloxegol Oxalate | 72 | $31K |
| Hydrocodone/Acetaminophen | 1,181 | $31K |
| Gabapentin | 1,710 | $30K |
| Diclofenac Sodium | 567 | $30K |
| Oxycodone Hcl | 77 | $29K |
Prescribing Profile
77
Unique Drugs
62.0
Anomaly Score
Patient Profile
69
Avg Age
64%
Female
2.07
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