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
53
Total Claims
$1,501
Drug Cost
30
Beneficiaries
$50
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,743 Pediatric Medicine providers
+2628%
Opioid rate vs peers
43.4% vs 1.6% avg
-98%
Cost per patient vs peers
$50 vs $2,098 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 2,628% 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
43.4%
Opioid Rate
23
Opioid Claims
$403
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 43.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 47 claims · $1,443
Patient Profile
83
Avg Age
63%
Female
2.85
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