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
28,467
Total Claims
$1.3M
Drug Cost
634
Beneficiaries
$2,120
Cost/Patient
Risk Score Breakdown 26/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,825 Geriatric Medicine providers
-49%
Opioid rate vs peers
1.3% vs 2.6% avg
+71%
Cost per patient vs peers
$2,120 vs $1,237 avg
+17%
Brand preference vs peers
10.7% vs 9.2% 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.
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
1.3%
Opioid Rate
373
Opioid Claims
$16K
Opioid Cost
15.8%
Long-Acting Rate
Brand vs Generic
Brand: 3,027 claims · $824K
Generic: 25,274 claims · $512K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 809 | $275K |
| Rivaroxaban | 247 | $83K |
| Mirabegron | 143 | $45K |
| Memantine Hcl | 953 | $31K |
| Lipase/Protease/Amylase | 19 | $27K |
| Sitagliptin Phosphate | 60 | $22K |
| Linagliptin | 58 | $21K |
| Atorvastatin Calcium | 1,714 | $21K |
| Potassium Chloride | 1,020 | $20K |
| Insulin Glargine,hum.Rec.Anlog | 95 | $19K |
| Empagliflozin | 27 | $17K |
| Insulin Aspart | 58 | $16K |
| Midodrine Hcl | 205 | $15K |
| Levothyroxine Sodium | 1,222 | $14K |
| Quetiapine Fumarate | 669 | $12K |
Prescribing Profile
Patient Profile
83
Avg Age
69%
Female
2.49
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