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
7,241
Total Claims
$4.4M
Drug Cost
148
Beneficiaries
$30K
Cost/Patient
Risk Score Breakdown 47/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+820%
Opioid rate vs peers
20.6% vs 2.2% avg
+2026%
Cost per patient vs peers
$30K vs $1,411 avg
+93%
Brand preference vs peers
20.5% 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 820% 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 2026% 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
20.6%
Opioid Rate
1,492
Opioid Claims
$599K
Opioid Cost
36.9%
Long-Acting Rate
This provider's opioid prescribing rate of 20.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,472 claims · $4.2M
Generic: 5,712 claims · $218K
Patient Profile
65
Avg Age
29%
Female
1.82
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