Shopify Mark Paypal Express Check Out Order As mid Risk

From the screenshot it looks like Shopify marked an order medium risk, this is the Shopify fraud analysis that helps stores determine the potential risk factor of an order.

Reference: https://help.shopify.com/en/manual/orders/fraud-analysis

In tests we’ve done with app users (for our app Order Automator that notifies store staff of medium / high risk orders), we’ve seen 20 - 30% of high risk orders be fraudulent resulting in a chargeback, but for medium risk much lower (some stores had a 0% chargeback rate for medium risk orders).

So I think generally medium risk orders are fine, but it might still be worth contacting the customer to verify. Shopify has some documentation on fraud prevention here: https://help.shopify.com/en/manual/payments/fraud-prevention