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
630
Total Claims
$5,398
Drug Cost
144
Beneficiaries
$37
Cost/Patient
Risk Score Breakdown 11/100
Score components are additive. Read full methodology
Peer Comparison vs. 17,619 Orthopedic Surgery providers
+5%
Opioid rate vs peers
32.5% vs 31.0% avg
🔎 Data Overview
Prescribes only 5 unique drugs with a 32.5% 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
32.5%
Opioid Rate
205
Opioid Claims
$2,029
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 32.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 628 claims · $4,792
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 166 | $1,743 |
| Ondansetron | 117 | $1,548 |
| Cephalexin | 161 | $574 |
| Diclofenac Sodium | 115 | $260 |
| Oxycodone Hcl | 18 | $135 |
Prescribing Profile
5
Unique Drugs
11.0
Anomaly Score
Patient Profile
74
Avg Age
60%
Female
1.12
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About