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
5,162
Total Claims
$587K
Drug Cost
337
Beneficiaries
$1,743
Cost/Patient
Risk Score Breakdown 26/100
Score components are additive. Read full methodology
Peer Comparison vs. 3,186 Anesthesiology providers
+96%
Opioid rate vs peers
68.3% vs 34.8% avg
+313%
Cost per patient vs peers
$1,743 vs $422 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
68.3%
Opioid Rate
3,524
Opioid Claims
$172K
Opioid Cost
30.8%
Long-Acting Rate
This provider's opioid prescribing rate of 68.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 4,899 claims · $143K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Tasimelteon | 14 | $325K |
| Oxycodone Hcl | 63 | $44K |
| Oxycodone Hcl | 1,350 | $32K |
| Erenumab-Aooe | 29 | $28K |
| Oxycodone Myristate | 34 | $23K |
| Hydrocodone/Acetaminophen | 524 | $17K |
| Morphine Sulfate | 477 | $11K |
| Fentanyl | 81 | $8,726 |
| Buprenorphine Hcl | 187 | $8,104 |
| Oxycodone Hcl/Acetaminophen | 130 | $7,642 |
| Pregabalin | 95 | $6,972 |
| Gabapentin | 283 | $6,762 |
| Buprenorphine Hcl/Naloxone Hcl | 55 | $6,493 |
| Methadone Hcl | 390 | $6,157 |
| Buprenorphine | 19 | $5,698 |
Prescribing Profile
39
Unique Drugs
26.0
Anomaly Score
Patient Profile
68
Avg Age
63%
Female
1.62
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