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
140
Total Claims
$354K
Drug Cost
14
Beneficiaries
$25K
Cost/Patient
Risk Score Breakdown 44/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1017%
Opioid rate vs peers
25.0% vs 2.2% avg
+1693%
Cost per patient vs peers
$25K vs $1,411 avg
+390%
Brand preference vs peers
52.1% 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 1,017% 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 1693% 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
25.0%
Opioid Rate
35
Opioid Claims
$21K
Opioid Cost
37.1%
Long-Acting Rate
This provider's opioid prescribing rate of 25.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 73 claims · $340K
Generic: 67 claims · $14K
Patient Profile
72
Avg Age
—
Female
2.41
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