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 →12
🟢 Low
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
9,858
Total Claims
$462K
Drug Cost
1,165
Beneficiaries
$397
Cost/Patient
Risk Score Breakdown 12/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+205%
Opioid rate vs peers
61.7% vs 20.2% avg
-13%
Cost per patient vs peers
$397 vs $455 avg
-21%
Brand preference vs peers
2.5% vs 3.1% avg
🔎 Data Overview
Opioid rate is 205% above Physical Medicine and Rehabilitation peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
61.7%
Opioid Rate
6,081
Opioid Claims
$329K
Opioid Cost
8.5%
Long-Acting Rate
This provider's opioid prescribing rate of 61.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 246 claims · $156K
Generic: 9,612 claims · $306K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 3,017 | $128K |
| Hydrocodone/Acetaminophen | 1,666 | $49K |
| Oxycodone Myristate | 57 | $47K |
| Oxycodone Hcl | 71 | $45K |
| Gabapentin | 1,875 | $29K |
| Pregabalin | 489 | $27K |
| Oxycodone Hcl | 735 | $26K |
| Naloxegol Oxalate | 23 | $11K |
| Gabapentin Enacarbil | 11 | $7,356 |
| Lidocaine | 27 | $6,359 |
| Buprenorphine Hcl | 11 | $4,966 |
| Tizanidine Hcl | 353 | $4,764 |
| Morphine Sulfate | 151 | $4,544 |
| Methadone Hcl | 168 | $4,135 |
| Naloxone Hcl | 58 | $4,087 |
Prescribing Profile
29
Unique Drugs
12.0
Anomaly Score
Patient Profile
64
Avg Age
66%
Female
1.84
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