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: 87%
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
292
Total Claims
$5,999
Drug Cost
16
Beneficiaries
$375
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 988 Specialist providers
+1052%
Opioid rate vs peers
57.9% vs 5.0% avg
-56%
Cost per patient vs peers
$375 vs $856 avg
+133%
Brand preference vs peers
19.2% vs 8.2% 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 87% indicates prescribing patterns with significant similarity to confirmed fraud cases. 17 out of 20 decision trees flagged this provider.
Opioid prescribing rate is 1,052% above the average for Specialist 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
57.9%
Opioid Rate
169
Opioid Claims
$4,897
Opioid Cost
27.2%
Long-Acting Rate
This provider's opioid prescribing rate of 57.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 56 claims · $1,866
Generic: 236 claims · $4,132
Patient Profile
60
Avg Age
—
Female
2.55
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