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
51
Total Claims
$397
Drug Cost
33
Beneficiaries
$12
Cost/Patient
Risk Score Breakdown 20/100
Score components are additive. Read full methodology
Peer Comparison vs. 380 Cardiac Surgery providers
+362%
Opioid rate vs peers
51.0% vs 11.0% avg
-96%
Cost per patient vs peers
$12 vs $312 avg
🔎 Data Overview
Opioid rate is 362% above Cardiac Surgery peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Prescribes only 2 unique drugs with a 51.0% 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
51.0%
Opioid Rate
26
Opioid Claims
$229
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 51.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 51 claims · $397
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 22 | $201 |
| Gabapentin | 21 | $136 |
Prescribing Profile
2
Unique Drugs
20.0
Anomaly Score
Patient Profile
71
Avg Age
64%
Female
2.01
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