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
2,096
Total Claims
$256K
Drug Cost
101
Beneficiaries
$2,536
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 988 Specialist providers
+1034%
Opioid rate vs peers
57.0% vs 5.0% avg
+196%
Cost per patient vs peers
$2,536 vs $856 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 1,034% above the average for Specialist 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
57.0%
Opioid Rate
1,194
Opioid Claims
$219K
Opioid Cost
19.8%
Long-Acting Rate
This provider's opioid prescribing rate of 57.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 172 claims · $160K
Generic: 1,924 claims · $96K
Patient Profile
64
Avg Age
39%
Female
2.23
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