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 →Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
142
Total Claims
$5,060
Drug Cost
80
Beneficiaries
$63
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 16,767 Hospitalist providers
+983%
Opioid rate vs peers
32.4% vs 3.0% avg
-85%
Cost per patient vs peers
$63 vs $427 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid prescribing rate is 983% above the average for Hospitalist providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 2 unique drugs with a 32.4% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
32.4%
Opioid Rate
46
Opioid Claims
$368
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 32.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 133 claims · $1,222
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 13 | $158 |
| Methocarbamol | 14 | $63 |
Prescribing Profile
2
Unique Drugs
31.0
Anomaly Score
Patient Profile
74
Avg Age
64%
Female
1.48
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