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: 84%
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
951
Total Claims
$46K
Drug Cost
43
Beneficiaries
$1,065
Cost/Patient
Risk Score Breakdown 35/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1212%
Opioid rate vs peers
49.6% vs 3.8% avg
-9%
Cost per patient vs peers
$1,065 vs $1,174 avg
-67%
Brand preference vs peers
2.9% vs 8.9% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
ML fraud detection score of 84% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 1,212% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
49.6%
Opioid Rate
472
Opioid Claims
$18K
Opioid Cost
14.8%
Long-Acting Rate
This provider's opioid prescribing rate of 49.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 28 claims · $20K
Generic: 923 claims · $26K
Patient Profile
63
Avg Age
51%
Female
1.17
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