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(C) during a period of three consecutive months, received an opioid prescription from two or more prescribers;

(D) during a period of three consecutive months, paid cash two or more times for a United States Drug Enforcement Administration-designated Schedule II - V drug;

(E) during a 30-day period, received concurrent prescriptions for an opioid and benzodiazepine from more than one prescriber;

(F) over a period of nine consecutive months or longer, was dispensed medication containing buprenorphine with an average daily dose of greater than 16 milligrams;

(G) during a period of not less than three consecutive months, used a medical item or service with a frequency that exceeds two standard deviations from the arithmetic mean of the frequency of use of the medical item or service by recipients of medical assistance programs administered by the department who have used the medical item or service as shown in the department’s most recent statistical analysis of usage of that medical item or service;

(H) during a period of 12 consecutive months, received treatment through an emergency department three or more times for a non-emergent condition;

(I) for a reason that was within the control of the recipient, traveled using department-authorized transportation and failed to receive services for which the travel was authorized; or

(J) during a period of six consecutive months, failed to keep three or more appointments for services covered under 7 AAC 105 — 7 AAC 160;

(2) a qualified health care professional employed by or designated by the department determines that a recipient’s use of Medicaid services was at a frequency or amount that is not medically necessary based on an evaluation of the recipient’s medical or billing history, and with consideration of one or more of the following:

(A) data from the prescription drug monitoring program (PDMP) controlled substance prescription database established under AS 17.30.200;

(B) application of clinical judgment using available information within the scope of practice of the qualified health care professional;

(C) the recipient’s age, diagnosis, complications, chronic illnesses, use of different medical providers and hospitals, and medical care received;

(D) a referral made to the department indicating that the recipient has used a medical item or service at a frequency or amount that is not appropriate; and

(E) other tracking tools or information available to the department. (c) Following identification of one or more instances identified in (b) of this section, the department will