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
84
Total Claims
$27K
Drug Cost
23
Beneficiaries
$1,157
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 775 Hematology providers
+951%
Opioid rate vs peers
53.6% vs 5.1% avg
-94%
Cost per patient vs peers
$1,157 vs $18K avg
-23%
Brand preference vs peers
17.9% vs 23.1% 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 951% above the average for Hematology providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
53.6%
Opioid Rate
45
Opioid Claims
$2,111
Opioid Cost
73.3%
Long-Acting Rate
This provider's opioid prescribing rate of 53.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 15 claims · $24K
Generic: 69 claims · $2,548
Patient Profile
53
Avg Age
—
Female
3.19
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