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
137
Total Claims
$188K
Drug Cost
16
Beneficiaries
$12K
Cost/Patient
Risk Score Breakdown 34/100
Score components are additive. Read full methodology
Peer Comparison vs. 16,767 Hospitalist providers
+1194%
Opioid rate vs peers
38.7% vs 3.0% avg
+2654%
Cost per patient vs peers
$12K vs $427 avg
+373%
Brand preference vs peers
24.8% vs 5.2% 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 1,194% above the average for Hospitalist providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 2654% 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
38.7%
Opioid Rate
53
Opioid Claims
$1,135
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 38.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 34 claims · $151K
Generic: 103 claims · $37K
Patient Profile
39
Avg Age
—
Female
5.84
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