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
20,420
Total Claims
$1.1M
Drug Cost
983
Beneficiaries
$1,126
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+345%
Opioid rate vs peers
16.8% vs 3.8% avg
-4%
Cost per patient vs peers
$1,126 vs $1,174 avg
-9%
Brand preference vs peers
8.1% 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 rate is 345% above Nurse Practitioner peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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
16.8%
Opioid Rate
3,435
Opioid Claims
$124K
Opioid Cost
22.4%
Long-Acting Rate
Brand vs Generic
Brand: 1,634 claims · $715K
Generic: 18,597 claims · $383K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 257 | $143K |
| Empagliflozin | 99 | $61K |
| Rivaroxaban | 86 | $57K |
| Dulaglutide | 51 | $49K |
| Hydrocodone/Acetaminophen | 1,721 | $38K |
| Mirabegron | 82 | $38K |
| Budesonide/Formoterol Fumarate | 89 | $37K |
| Aripiprazole | 13 | $36K |
| Oxycodone Hcl | 46 | $30K |
| Insulin Glargine,hum.Rec.Anlog | 84 | $27K |
| Insulin Aspart | 41 | $20K |
| Sitagliptin Phosphate | 32 | $17K |
| Dapagliflozin Propanediol | 25 | $15K |
| Sacubitril/Valsartan | 15 | $14K |
| Tiotropium Bromide | 26 | $14K |
Prescribing Profile
Patient Profile
72
Avg Age
64%
Female
1.86
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