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
132
Total Claims
$14K
Drug Cost
69
Beneficiaries
$207
Cost/Patient
Risk Score Breakdown 6/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,124 General Surgery providers
-27%
Opioid rate vs peers
22.0% vs 30.2% avg
-18%
Cost per patient vs peers
$207 vs $253 avg
+128%
Brand preference vs peers
11.4% vs 5.0% avg
🔎 Data Overview
Prescribes only 5 unique drugs with a 22.0% 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
22.0%
Opioid Rate
29
Opioid Claims
$69
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 22.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 15 claims · $13K
Generic: 117 claims · $1,407
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Apixaban | 13 | $11K |
| Clopidogrel Bisulfate | 33 | $734 |
| Atorvastatin Calcium | 27 | $258 |
| Cilostazol | 12 | $223 |
| Oxycodone Hcl | 26 | $61 |
Prescribing Profile
Patient Profile
75
Avg Age
45%
Female
4.11
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