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
6,432
Total Claims
$966K
Drug Cost
187
Beneficiaries
$5,166
Cost/Patient
Risk Score Breakdown 59/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,194 Neurology providers
+2412%
Opioid rate vs peers
32.9% vs 1.3% avg
+28%
Cost per patient vs peers
$5,166 vs $4,034 avg
+54%
Brand preference vs peers
14.5% vs 9.4% 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 2,412% above the average for Neurology providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 59/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
32.9%
Opioid Rate
2,113
Opioid Claims
$570K
Opioid Cost
42.0%
Long-Acting Rate
This provider's opioid prescribing rate of 32.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 931 claims · $767K
Generic: 5,501 claims · $199K
Patient Profile
69
Avg Age
59%
Female
1.44
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