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
188
Total Claims
$3,424
Drug Cost
130
Beneficiaries
$26
Cost/Patient
Risk Score Breakdown 24/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+766%
Opioid rate vs peers
22.3% vs 2.6% avg
-98%
Cost per patient vs peers
$26 vs $1,068 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 766% above the average for Family Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 2 unique drugs with a 22.3% 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
22.3%
Opioid Rate
42
Opioid Claims
$265
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 22.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 177 claims · $2,012
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 36 | $225 |
| Prednisone | 20 | $132 |
Prescribing Profile
2
Unique Drugs
24.0
Anomaly Score
Patient Profile
73
Avg Age
60%
Female
1.24
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