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
93
Total Claims
$227K
Drug Cost
19
Beneficiaries
$12K
Cost/Patient
Risk Score Breakdown 39/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+1149%
Opioid rate vs peers
28.0% vs 2.2% avg
+748%
Cost per patient vs peers
$12K vs $1,411 avg
+62%
Brand preference vs peers
17.2% vs 10.6% 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 1,149% 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 748% 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
28.0%
Opioid Rate
26
Opioid Claims
$254
Opioid Cost
96.2%
Long-Acting Rate
This provider's opioid prescribing rate of 28.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 16 claims · $224K
Generic: 77 claims · $3,920
Patient Profile
61
Avg Age
—
Female
1.11
Avg Risk Score
Explore More
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