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
3,136
Total Claims
$5.7M
Drug Cost
400
Beneficiaries
$14K
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1128%
Opioid rate vs peers
27.5% vs 2.2% avg
+917%
Cost per patient vs peers
$14K vs $1,411 avg
+40%
Brand preference vs peers
14.9% 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 1,128% 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 917% 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
27.5%
Opioid Rate
862
Opioid Claims
$19K
Opioid Cost
15.4%
Long-Acting Rate
This provider's opioid prescribing rate of 27.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 467 claims · $5.3M
Generic: 2,669 claims · $439K
Patient Profile
70
Avg Age
55%
Female
2.56
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