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
335
Total Claims
$2.0M
Drug Cost
66
Beneficiaries
$31K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+540%
Opioid rate vs peers
14.3% vs 2.2% avg
+2084%
Cost per patient vs peers
$31K vs $1,411 avg
+310%
Brand preference vs peers
43.6% 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 540% 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 2084% 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
14.3%
Opioid Rate
48
Opioid Claims
$12K
Opioid Cost
22.9%
Long-Acting Rate
Brand vs Generic
Brand: 146 claims · $1.9M
Generic: 189 claims · $173K
Patient Profile
64
Avg Age
70%
Female
3.53
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