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
670
Total Claims
$2.5M
Drug Cost
113
Beneficiaries
$22K
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+720%
Opioid rate vs peers
18.4% vs 2.2% avg
+1446%
Cost per patient vs peers
$22K vs $1,411 avg
+168%
Brand preference vs peers
28.5% 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 720% 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 1446% 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
18.4%
Opioid Rate
123
Opioid Claims
$8,994
Opioid Cost
26.0%
Long-Acting Rate
Brand vs Generic
Brand: 191 claims · $2.0M
Generic: 479 claims · $426K
Patient Profile
67
Avg Age
57%
Female
2.63
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