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
5,188
Total Claims
$6.1M
Drug Cost
505
Beneficiaries
$12K
Cost/Patient
Risk Score Breakdown 48/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+640%
Opioid rate vs peers
16.6% vs 2.2% avg
+756%
Cost per patient vs peers
$12K vs $1,411 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 640% 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 756% 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
16.6%
Opioid Rate
859
Opioid Claims
$49K
Opioid Cost
22.6%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 4,480 claims · $528K
Patient Profile
73
Avg Age
65%
Female
2.50
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