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
139
Total Claims
$811K
Drug Cost
42
Beneficiaries
$19K
Cost/Patient
Risk Score Breakdown 14/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,928 Gastroenterology providers
+887%
Cost per patient vs peers
$19K vs $1,956 avg
+230%
Brand preference vs peers
47.5% vs 14.4% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Cost per patient is 887% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Brand vs Generic
Brand: 66 claims · $792K
Generic: 73 claims · $19K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Ustekinumab | 23 | $615K |
| Vedolizumab | 13 | $111K |
| Mesalamine | 11 | $12K |
Prescribing Profile
Patient Profile
69
Avg Age
55%
Female
1.75
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