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
455
Total Claims
$75K
Drug Cost
36
Beneficiaries
$2,089
Cost/Patient
Risk Score Breakdown 43/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+2178%
Opioid rate vs peers
51.0% vs 2.2% avg
+48%
Cost per patient vs peers
$2,089 vs $1,411 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 2,178% above the average for Internal Medicine 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
51.0%
Opioid Rate
232
Opioid Claims
$58K
Opioid Cost
34.9%
Long-Acting Rate
This provider's opioid prescribing rate of 51.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 391 claims · $13K
Patient Profile
62
Avg Age
61%
Female
1.26
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