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
1,252
Total Claims
$4.3M
Drug Cost
169
Beneficiaries
$25K
Cost/Patient
Risk Score Breakdown 53/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+2312%
Opioid rate vs peers
54.0% vs 2.2% avg
+1688%
Cost per patient vs peers
$25K 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 2,312% 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 1688% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Composite risk score of 53/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
54.0%
Opioid Rate
676
Opioid Claims
$68K
Opioid Cost
32.8%
Long-Acting Rate
This provider's opioid prescribing rate of 54.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 943 claims · $1.0M
Patient Profile
57
Avg Age
56%
Female
3.14
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 of wrongdoing.Methodology · About · Dispute this data