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RA
Ruth Alvarez
High RiskSyntheticP-1572 · 72 y/o · Female · Commercial HMO · West · PCP Dr. Reyes · Member since 2006
98
Sample riskMock model
$2120
Cost PMPMClaims
ConditionsClinical
- Chronic Kidney Disease
- Heart Failure
Recent utilizationUtilization
Last 12 months
3
Admissions
3
ED visits
Yes
30d readmit
MedicationsPharmacy
- Losartan 50mg daily
- Carvedilol 12.5mg BID
- Furosemide 40mg daily
Open care gapsQuality
- Post-discharge follow-upOpen
- Statin therapy reviewOpen
20-year illustrative historyLongitudinal (synthetic)
Annual encounters and cost
Care manager review
Manual approval required before outreach
Current role: Executive. Approval requires Care Manager or Clinical Reviewer.
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