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
26,146
Total Claims
$1.1M
Drug Cost
1,933
Beneficiaries
$591
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,621 Pain Management providers
+66%
Opioid rate vs peers
68.3% vs 41.3% avg
+48%
Cost per patient vs peers
$591 vs $399 avg
+20%
Brand preference vs peers
4.5% vs 3.8% avg
⚠️ Opioid + Benzodiazepine Co-Prescriber
This provider prescribes both opioids and benzodiazepines. The FDA has issued a Black Box Warning about the life-threatening risks of concurrent use.
🔎 Data Overview
This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
68.3%
Opioid Rate
17,855
Opioid Claims
$806K
Opioid Cost
25.4%
Long-Acting Rate
This provider's opioid prescribing rate of 68.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,174 claims · $401K
Generic: 24,972 claims · $742K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 380 | $179K |
| Hydrocodone/Acetaminophen | 4,568 | $140K |
| Oxycodone Hcl/Acetaminophen | 2,545 | $105K |
| Oxycodone Hcl | 189 | $86K |
| Oxycodone Hcl | 3,983 | $83K |
| Fentanyl | 1,005 | $61K |
| Buprenorphine Hcl/Naloxone Hcl | 207 | $43K |
| Morphine Sulfate | 1,771 | $42K |
| Tapentadol Hcl | 23 | $35K |
| Pregabalin | 704 | $34K |
| Duloxetine Hcl | 586 | $20K |
| Pregabalin | 11 | $18K |
| Tramadol Hcl | 1,486 | $17K |
| Gabapentin | 684 | $16K |
| Methadone Hcl | 1,126 | $16K |
Prescribing Profile
61
Unique Drugs
38.0
Anomaly Score
Patient Profile
70
Avg Age
55%
Female
2.49
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