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
176
Total Claims
$257K
Drug Cost
36
Beneficiaries
$7,152
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 616 Sleep Medicine providers
+2231%
Opioid rate vs peers
36.9% vs 1.6% avg
+223%
Cost per patient vs peers
$7,152 vs $2,215 avg
-9%
Brand preference vs peers
13.1% vs 14.3% 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 2,231% above the average for Sleep 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
36.9%
Opioid Rate
65
Opioid Claims
$553
Opioid Cost
76.9%
Long-Acting Rate
This provider's opioid prescribing rate of 36.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 23 claims · $148K
Generic: 153 claims · $110K
Patient Profile
70
Avg Age
56%
Female
1.05
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