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
214
Total Claims
$710K
Drug Cost
37
Beneficiaries
$19K
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+672%
Opioid rate vs peers
17.3% vs 2.2% avg
+1260%
Cost per patient vs peers
$19K 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 672% 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 1260% 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
17.3%
Opioid Rate
37
Opioid Claims
$13K
Opioid Cost
37.8%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 107 claims · $3,634
Patient Profile
68
Avg Age
65%
Female
3.26
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