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
410
Total Claims
$790K
Drug Cost
76
Beneficiaries
$10K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+870%
Opioid rate vs peers
21.7% vs 2.2% avg
+637%
Cost per patient vs peers
$10K vs $1,411 avg
+58%
Brand preference vs peers
16.8% vs 10.6% 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 870% 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 637% 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
21.7%
Opioid Rate
89
Opioid Claims
$2,630
Opioid Cost
28.1%
Long-Acting Rate
This provider's opioid prescribing rate of 21.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 69 claims · $528K
Generic: 341 claims · $262K
Patient Profile
69
Avg Age
40%
Female
2.74
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