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 →33
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
94
Total Claims
$333
Drug Cost
75
Beneficiaries
$4
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,293 Plastic and Reconstructive Surgery providers
+242%
Opioid rate vs peers
88.3% vs 25.8% avg
-96%
Cost per patient vs peers
$4 vs $102 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid rate is 242% above Plastic and Reconstructive Surgery peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
88.3%
Opioid Rate
83
Opioid Claims
$223
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 88.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 94 claims · $333
Patient Profile
68
Avg Age
60%
Female
1.25
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