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
185
Total Claims
$149K
Drug Cost
59
Beneficiaries
$2,534
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,928 Gastroenterology providers
+30%
Cost per patient vs peers
$2,534 vs $1,956 avg
+73%
Brand preference vs peers
24.9% vs 14.4% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Prescribes only 5 unique drugs with a 21.6% 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
21.6%
Opioid Rate
40
Opioid Claims
$452
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 21.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 46 claims · $145K
Generic: 139 claims · $4,313
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Lipase/Protease/Amylase | 38 | $130K |
| Omeprazole | 31 | $423 |
| Pantoprazole Sodium | 25 | $394 |
| Oxycodone Hcl | 17 | $243 |
| Tramadol Hcl | 11 | $26 |
Prescribing Profile
5
Unique Drugs
31.0
Anomaly Score
Patient Profile
68
Avg Age
49%
Female
2.12
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