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
123
Total Claims
$8,547
Drug Cost
16
Beneficiaries
$534
Cost/Patient
Risk Score Breakdown 39/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,743 Pediatric Medicine providers
+4091%
Opioid rate vs peers
66.7% vs 1.6% avg
-75%
Cost per patient vs peers
$534 vs $2,098 avg
+8%
Brand preference vs peers
16.3% vs 15.1% 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 4,091% above the average for Pediatric Medicine 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
66.7%
Opioid Rate
82
Opioid Claims
$6,807
Opioid Cost
47.6%
Long-Acting Rate
This provider's opioid prescribing rate of 66.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 20 claims · $4,982
Generic: 103 claims · $3,564
Patient Profile
71
Avg Age
—
Female
3.00
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