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
366
Total Claims
$921K
Drug Cost
72
Beneficiaries
$13K
Cost/Patient
Risk Score Breakdown 28/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1011%
Opioid rate vs peers
24.9% vs 2.2% avg
+807%
Cost per patient vs peers
$13K 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 1,011% 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 807% 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
24.9%
Opioid Rate
91
Opioid Claims
$2,831
Opioid Cost
16.5%
Long-Acting Rate
This provider's opioid prescribing rate of 24.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 289 claims · $188K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Lenvatinib Mesylate | 24 | $596K |
| Everolimus | 11 | $181K |
| Oxycodone Hcl | 50 | $1,232 |
| Oxycodone Hcl/Acetaminophen | 13 | $622 |
| Hydrocodone/Acetaminophen | 11 | $457 |
| Morphine Sulfate | 14 | $422 |
| Prochlorperazine Maleate | 14 | $275 |
| Levothyroxine Sodium | 15 | $229 |
| Ondansetron Hcl | 12 | $220 |
| Ondansetron | 12 | $174 |
| Gabapentin | 11 | $145 |
| Pantoprazole Sodium | 11 | $130 |
| Spironolactone | 11 | $84 |
Prescribing Profile
13
Unique Drugs
28.0
Anomaly Score
Patient Profile
71
Avg Age
64%
Female
3.18
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