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 →11
🟢 Low
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
269
Total Claims
$1,773
Drug Cost
174
Beneficiaries
$10
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,293 Plastic and Reconstructive Surgery providers
+32%
Opioid rate vs peers
34.2% vs 25.8% avg
-90%
Cost per patient vs peers
$10 vs $102 avg
🔎 Data Overview
Prescribes only 3 unique drugs with a 34.2% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
34.2%
Opioid Rate
92
Opioid Claims
$163
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 34.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 267 claims · $1,146
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Sulfamethoxazole/Trimethoprim | 131 | $448 |
| Doxycycline Hyclate | 29 | $321 |
| Tramadol Hcl | 83 | $104 |
Prescribing Profile
3
Unique Drugs
11.0
Anomaly Score
Patient Profile
72
Avg Age
53%
Female
1.11
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 of wrongdoing.Methodology · About · Dispute this data