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
1,290
Total Claims
$2.5M
Drug Cost
247
Beneficiaries
$10K
Cost/Patient
Risk Score Breakdown 28/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+755%
Opioid rate vs peers
19.1% vs 2.2% avg
+617%
Cost per patient vs peers
$10K vs $1,411 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 755% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 617% 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.
Opioid Prescribing
19.1%
Opioid Rate
247
Opioid Claims
$8,121
Opioid Cost
17.0%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 737 claims · $41K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Lenalidomide | 33 | $604K |
| Ibrutinib | 17 | $293K |
| Nilotinib Hcl | 14 | $255K |
| Abemaciclib | 13 | $197K |
| Enzalutamide | 13 | $190K |
| Osimertinib Mesylate | 12 | $185K |
| Apixaban | 256 | $179K |
| Rivaroxaban | 135 | $119K |
| Hydrocodone/Acetaminophen | 137 | $3,930 |
| Fentanyl | 24 | $2,033 |
| Midodrine Hcl | 11 | $1,940 |
| Hydroxyurea | 25 | $1,375 |
| Hydromorphone Hcl | 23 | $1,116 |
| Anastrozole | 37 | $870 |
| Pantoprazole Sodium | 60 | $814 |
Prescribing Profile
Patient Profile
74
Avg Age
56%
Female
2.61
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