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: 83%
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
8,948
Total Claims
$599K
Drug Cost
585
Beneficiaries
$1,024
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+360%
Opioid rate vs peers
42.3% vs 9.2% avg
+42%
Cost per patient vs peers
$1,024 vs $719 avg
+35%
Brand preference vs peers
9.0% vs 6.7% 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 83% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid rate is 360% above Physician Assistant 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
42.3%
Opioid Rate
3,787
Opioid Claims
$289K
Opioid Cost
13.2%
Long-Acting Rate
This provider's opioid prescribing rate of 42.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 797 claims · $404K
Generic: 8,101 claims · $192K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl | 171 | $155K |
| Hydrocodone/Acetaminophen | 2,285 | $63K |
| Apixaban | 46 | $27K |
| Buprenorphine Hcl/Naloxone Hcl | 13 | $18K |
| Oxycodone Myristate | 53 | $17K |
| Morphine Sulfate | 166 | $11K |
| Gabapentin | 687 | $11K |
| Sitagliptin Phosphate | 18 | $10K |
| Oxycodone Hcl/Acetaminophen | 300 | $9,165 |
| Fluticasone/Umeclidin/Vilanter | 13 | $8,917 |
| Rivaroxaban | 15 | $8,462 |
| Acetaminophen With Codeine | 247 | $7,892 |
| Insulin Glargine,hum.Rec.Anlog | 16 | $7,724 |
| Insulin Glargine,hum.Rec.Anlog | 18 | $6,570 |
| Oxycodone Hcl | 14 | $6,296 |
Prescribing Profile
Patient Profile
68
Avg Age
59%
Female
2.17
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