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
820
Total Claims
$52K
Drug Cost
133
Beneficiaries
$390
Cost/Patient
Risk Score Breakdown 43/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+2161%
Opioid rate vs peers
58.3% vs 2.6% avg
-63%
Cost per patient vs peers
$390 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 2,161% 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
58.3%
Opioid Rate
478
Opioid Claims
$45K
Opioid Cost
34.5%
Long-Acting Rate
This provider's opioid prescribing rate of 58.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 752 claims · $20K
Patient Profile
64
Avg Age
47%
Female
1.87
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