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 →5
🟢 Low
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
60
Total Claims
$679
Drug Cost
45
Beneficiaries
$15
Cost/Patient
Risk Score Breakdown 5/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,293 Plastic and Reconstructive Surgery providers
+81%
Opioid rate vs peers
46.7% vs 25.8% avg
-85%
Cost per patient vs peers
$15 vs $102 avg
🔎 Data Overview
Prescribes only 2 unique drugs with a 46.7% 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
46.7%
Opioid Rate
28
Opioid Claims
$122
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 46.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 58 claims · $382
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Cephalexin | 18 | $112 |
| Tramadol Hcl | 15 | $39 |
Prescribing Profile
2
Unique Drugs
5.0
Anomaly Score
Patient Profile
67
Avg Age
—
Female
1.13
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