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
1,473
Total Claims
$2.7M
Drug Cost
117
Beneficiaries
$23K
Cost/Patient
Risk Score Breakdown 53/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+2202%
Opioid rate vs peers
51.5% vs 2.2% avg
+1515%
Cost per patient vs peers
$23K vs $1,411 avg
+172%
Brand preference vs peers
28.9% 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 2,202% 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 1515% 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
51.5%
Opioid Rate
759
Opioid Claims
$167K
Opioid Cost
26.4%
Long-Acting Rate
This provider's opioid prescribing rate of 51.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 426 claims · $2.5M
Generic: 1,047 claims · $203K
Patient Profile
44
Avg Age
64%
Female
4.97
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