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
170
Total Claims
$373K
Drug Cost
29
Beneficiaries
$13K
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+793%
Opioid rate vs peers
20.0% vs 2.2% avg
+810%
Cost per patient vs peers
$13K vs $1,411 avg
+166%
Brand preference vs peers
28.2% 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 793% 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 810% 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
20.0%
Opioid Rate
34
Opioid Claims
$1,172
Opioid Cost
50.0%
Long-Acting Rate
Brand vs Generic
Brand: 48 claims · $368K
Generic: 122 claims · $4,350
Patient Profile
70
Avg Age
52%
Female
2.10
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