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
546
Total Claims
$102K
Drug Cost
32
Beneficiaries
$3,175
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+603%
Opioid rate vs peers
64.7% vs 9.2% avg
+341%
Cost per patient vs peers
$3,175 vs $719 avg
+134%
Brand preference vs peers
15.6% vs 6.7% 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 90% indicates prescribing patterns with significant similarity to confirmed fraud cases. 18 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 603% above the average for Physician Assistant 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
64.7%
Opioid Rate
353
Opioid Claims
$85K
Opioid Cost
24.4%
Long-Acting Rate
This provider's opioid prescribing rate of 64.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 85 claims · $75K
Generic: 461 claims · $27K
Patient Profile
61
Avg Age
56%
Female
1.29
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