Medicare Part B Drug Waste Anomaly Detection & Program Integrity System

Composite risk scoring framework analyzing 824 injectable drugs across 1.2M providers

$1.87B
Total Drug Waste Analyzed
$189.7M
Anomalous Patterns Identified
94.3%
Audit Concordance
824
Drugs Analyzed
1.2M
Provider Records
92
High Risk Drugs Flagged
Geographic Distribution of Anomalies
Risk Grade Distribution (824 Drugs)
MWARI Component Weights
Specialty Waste Patterns
Model Performance Metrics
81.8%
F1 Score
100%
Recall
69.2%
Precision
87.3%
Accuracy
0.924
AUC ROC
4.7hrs
Processing Time
Top 5 High Risk Drugs by MWARI Score
Rank HCPCS Drug Name MWARI Score Waste Rate Financial Impact
1 J3299 Injection, triamcinolone 95.5 81.6% $1,616,004
2 Q9965 Low osmolar contrast material 92.2 68.4% $1,460,356
3 J9281 Mitomycin injection 89.3 44.3% $16,967,542
4 J3101 Injection, tenecteplase 87.4 33.2% $11,473,212
5 J9043 Cabazitaxel injection 86.0 31.0% $38,553,000
Key Findings
2.3x
Higher waste in rural areas
85.9%
Waste in 11.2% of drugs
45
Critical Priority Drugs (D and F)
100%
Recall (No Anomalies Missed)
Note: This system identifies statistical patterns warranting investigation. Determination of actual improper payments requires investigation by authorized agencies. As stated by CMS, improper payment estimates are not measures of fraud. Data source: CMS Public Datasets (2017 to 2024).