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 →🤖 ML Fraud Detection Score: 91%
Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
396
Total Claims
$53K
Drug Cost
27
Beneficiaries
$1,949
Cost/Patient
Risk Score Breakdown 48/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+2980%
Opioid rate vs peers
68.9% vs 2.2% avg
+38%
Cost per patient vs peers
$1,949 vs $1,411 avg
+33%
Brand preference vs peers
14.1% vs 10.6% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
Opioid Prescribing
68.9%
Opioid Rate
273
Opioid Claims
$37K
Opioid Cost
28.6%
Long-Acting Rate
This provider's opioid prescribing rate of 68.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 56 claims · $46K
Generic: 340 claims · $6,243
Patient Profile
63
Avg Age
44%
Female
1.42
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