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
69
Total Claims
$440
Drug Cost
38
Beneficiaries
$12
Cost/Patient
Risk Score Breakdown 28/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,414 Sports Medicine providers
+349%
Opioid rate vs peers
68.1% vs 15.2% avg
-90%
Cost per patient vs peers
$12 vs $116 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid rate is 349% above Sports Medicine peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Prescribes only 2 unique drugs with a 68.1% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
68.1%
Opioid Rate
47
Opioid Claims
$165
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 68.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 69 claims · $440
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 22 | $78 |
| Oxycodone Hcl/Acetaminophen | 12 | $56 |
Prescribing Profile
2
Unique Drugs
28.0
Anomaly Score
Patient Profile
66
Avg Age
—
Female
1.12
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.Methodology · About