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
3,830
Total Claims
$400K
Drug Cost
757
Beneficiaries
$528
Cost/Patient
Risk Score Breakdown 50/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+2585%
Opioid rate vs peers
69.2% vs 2.6% avg
-51%
Cost per patient vs peers
$528 vs $1,068 avg
+34%
Brand preference vs peers
12.0% vs 9.0% 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 2,585% above the average for Family Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 50/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
69.2%
Opioid Rate
2,652
Opioid Claims
$339K
Opioid Cost
32.4%
Long-Acting Rate
This provider's opioid prescribing rate of 69.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 461 claims · $272K
Generic: 3,369 claims · $128K
Patient Profile
66
Avg Age
65%
Female
1.78
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