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
73
Total Claims
$7,692
Drug Cost
38
Beneficiaries
$202
Cost/Patient
Risk Score Breakdown 18/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+879%
Opioid rate vs peers
21.9% vs 2.2% avg
-86%
Cost per patient vs peers
$202 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 879% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 1 unique drugs with a 21.9% 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
21.9%
Opioid Rate
16
Opioid Claims
$65
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 21.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 68 claims · $6,562
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 12 | $54 |
Prescribing Profile
1
Unique Drugs
18.0
Anomaly Score
Patient Profile
70
Avg Age
53%
Female
3.61
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