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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.

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Sebastian KsionskiMD

Pain Management · Lynchburg, VA 24503

NPI: 1033120852

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12

🟢 Low

Risk Flags

95th percentile opioid prescribing

Risk indicators are statistical patterns, not allegations. Learn more

5,328

Total Claims

$187K

Drug Cost

511

Beneficiaries

$366

Cost/Patient

Risk Score Breakdown 12/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate (national percentile)+10

Score components are additive. Read full methodology

Peer Comparison vs. 2,621 Pain Management providers

+46%

Opioid rate vs peers

60.2% vs 41.3% avg

-8%

Cost per patient vs peers

$366 vs $399 avg

-10%

Brand preference vs peers

3.4% vs 3.8% avg

Opioid Prescribing

60.2%

Opioid Rate

3,206

Opioid Claims

$132K

Opioid Cost

14.6%

Long-Acting Rate

This provider's opioid prescribing rate of 60.2% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

97% generic

Brand: 181 claims · $59K

Generic: 5,147 claims · $128K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Oxycodone Hcl75$27K
Hydrocodone/Acetaminophen1,114$23K
Oxycodone Hcl/Acetaminophen746$20K
Pregabalin305$19K
Gabapentin636$15K
Fentanyl110$11K
Buprenorphine Hcl21$9,750
Buprenorphine11$9,187
Oxycodone Myristate27$7,998
Morphine Sulfate165$6,286
Oxycodone Hcl394$6,067
Buprenorphine14$3,743
Diclofenac Sodium248$3,255
Lidocaine16$2,313
Tramadol Hcl314$1,994

Prescribing Profile

26

Unique Drugs

12.0

Anomaly Score

Patient Profile

68

Avg Age

65%

Female

1.61

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