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
910
Total Claims
$27K
Drug Cost
160
Beneficiaries
$166
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+1379%
Opioid rate vs peers
38.1% vs 2.6% avg
-84%
Cost per patient vs peers
$166 vs $1,068 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 1,379% above the average for Family Practice 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
38.1%
Opioid Rate
347
Opioid Claims
$11K
Opioid Cost
3.7%
Long-Acting Rate
This provider's opioid prescribing rate of 38.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 900 claims · $24K
Patient Profile
66
Avg Age
49%
Female
0.87
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