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
68
Total Claims
$97K
Drug Cost
27
Beneficiaries
$3,609
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,743 Pediatric Medicine providers
+2581%
Opioid rate vs peers
42.6% vs 1.6% avg
+72%
Cost per patient vs peers
$3,609 vs $2,098 avg
+27%
Brand preference vs peers
19.1% vs 15.1% 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 2,581% 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
42.6%
Opioid Rate
29
Opioid Claims
$1,343
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 42.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 13 claims · $80K
Generic: 55 claims · $17K
Patient Profile
38
Avg Age
48%
Female
5.14
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