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
1,115
Total Claims
$2.0M
Drug Cost
109
Beneficiaries
$18K
Cost/Patient
Risk Score Breakdown 53/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,928 Gastroenterology providers
+822%
Cost per patient vs peers
$18K vs $1,956 avg
+154%
Brand preference vs peers
36.6% vs 14.4% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Cost per patient is 822% 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
49.2%
Opioid Rate
549
Opioid Claims
$106K
Opioid Cost
39.9%
Long-Acting Rate
This provider's opioid prescribing rate of 49.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 408 claims · $1.9M
Generic: 707 claims · $38K
Patient Profile
65
Avg Age
56%
Female
2.03
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