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
194
Total Claims
$1.0M
Drug Cost
37
Beneficiaries
$27K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 16,767 Hospitalist providers
+538%
Opioid rate vs peers
19.1% vs 3.0% avg
+6269%
Cost per patient vs peers
$27K vs $427 avg
+647%
Brand preference vs peers
39.2% vs 5.2% 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 538% above the average for Hospitalist providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 6269% 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
19.1%
Opioid Rate
37
Opioid Claims
$4,662
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 76 claims · $1.0M
Generic: 118 claims · $2,591
Patient Profile
68
Avg Age
60%
Female
3.21
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