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
304
Total Claims
$23K
Drug Cost
37
Beneficiaries
$613
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,743 Pediatric Medicine providers
+2506%
Opioid rate vs peers
41.4% vs 1.6% avg
-71%
Cost per patient vs peers
$613 vs $2,098 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 2,506% above the average for Pediatric Medicine 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
41.4%
Opioid Rate
126
Opioid Claims
$2,171
Opioid Cost
73.0%
Long-Acting Rate
This provider's opioid prescribing rate of 41.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 289 claims · $11K
Patient Profile
72
Avg Age
60%
Female
2.85
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