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
298
Total Claims
$15K
Drug Cost
146
Beneficiaries
$105
Cost/Patient
Risk Score Breakdown 6/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+365%
Opioid rate vs peers
10.4% vs 2.2% avg
-93%
Cost per patient vs peers
$105 vs $1,411 avg
-37%
Brand preference vs peers
6.7% vs 10.6% avg
🔎 Data Overview
Opioid rate is 365% above Internal Medicine peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Prescribes only 5 unique drugs, which is unusually low. Most providers prescribe 30+ different medications. Narrow prescribing patterns deserve context about the provider's practice scope.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
10.4%
Opioid Rate
31
Opioid Claims
$159
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 20 claims · $9,456
Generic: 278 claims · $5,941
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Amoxicillin/Potassium Clav | 35 | $253 |
| Cefdinir | 13 | $171 |
| Hydrocodone/Acetaminophen | 20 | $119 |
| Levofloxacin | 16 | $114 |
| Metoprolol Succinate | 11 | $84 |
Prescribing Profile
5
Unique Drugs
6.0
Anomaly Score
Patient Profile
75
Avg Age
57%
Female
2.22
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