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
497
Total Claims
$16K
Drug Cost
81
Beneficiaries
$200
Cost/Patient
Risk Score Breakdown 35/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+1897%
Opioid rate vs peers
51.5% vs 2.6% avg
-81%
Cost per patient vs peers
$200 vs $1,068 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 1,897% above the average for Family Practice 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
51.5%
Opioid Rate
256
Opioid Claims
$8,031
Opioid Cost
10.5%
Long-Acting Rate
This provider's opioid prescribing rate of 51.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 470 claims · $11K
Patient Profile
71
Avg Age
47%
Female
2.85
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