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
259
Total Claims
$209K
Drug Cost
26
Beneficiaries
$8,054
Cost/Patient
Risk Score Breakdown 34/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+518%
Opioid rate vs peers
56.8% vs 9.2% avg
+1020%
Cost per patient vs peers
$8,054 vs $719 avg
+103%
Brand preference vs peers
13.5% vs 6.7% 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 518% above the average for Physician Assistant providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 1020% 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
56.8%
Opioid Rate
147
Opioid Claims
$3,558
Opioid Cost
23.1%
Long-Acting Rate
This provider's opioid prescribing rate of 56.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 35 claims · $38K
Generic: 224 claims · $171K
Patient Profile
35
Avg Age
46%
Female
4.06
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