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
2,620
Total Claims
$767K
Drug Cost
55
Beneficiaries
$14K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+567%
Opioid rate vs peers
14.9% vs 2.2% avg
+889%
Cost per patient vs peers
$14K vs $1,411 avg
+89%
Brand preference vs peers
20.1% vs 10.6% avg
🔎 Data Overview
Opioid prescribing rate is 567% 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 889% 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
14.9%
Opioid Rate
391
Opioid Claims
$12K
Opioid Cost
15.1%
Long-Acting Rate
Brand vs Generic
Brand: 513 claims · $706K
Generic: 2,045 claims · $60K
Patient Profile
69
Avg Age
46%
Female
1.74
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