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
216
Total Claims
$2,237
Drug Cost
186
Beneficiaries
$12
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 380 Cardiac Surgery providers
+748%
Opioid rate vs peers
93.5% vs 11.0% avg
-96%
Cost per patient vs peers
$12 vs $312 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 748% above the average for Cardiac Surgery providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
93.5%
Opioid Rate
202
Opioid Claims
$1,556
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 93.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 215 claims · $1,597
Patient Profile
70
Avg Age
37%
Female
1.47
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