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
334
Total Claims
$753K
Drug Cost
82
Beneficiaries
$9,181
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+823%
Opioid rate vs peers
20.7% vs 2.2% avg
+551%
Cost per patient vs peers
$9,181 vs $1,411 avg
+52%
Brand preference vs peers
16.2% vs 10.6% 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 823% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 551% 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
20.7%
Opioid Rate
69
Opioid Claims
$969
Opioid Cost
21.7%
Long-Acting Rate
This provider's opioid prescribing rate of 20.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 54 claims · $646K
Generic: 280 claims · $107K
Patient Profile
74
Avg Age
55%
Female
3.24
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