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: 86%
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
3,171
Total Claims
$165K
Drug Cost
579
Beneficiaries
$284
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1393%
Opioid rate vs peers
56.5% vs 3.8% avg
-76%
Cost per patient vs peers
$284 vs $1,174 avg
-77%
Brand preference vs peers
2.1% 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 86% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 1,393% 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
56.5%
Opioid Rate
1,791
Opioid Claims
$91K
Opioid Cost
8.2%
Long-Acting Rate
This provider's opioid prescribing rate of 56.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 66 claims · $25K
Generic: 3,105 claims · $140K
Patient Profile
63
Avg Age
56%
Female
1.98
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