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 →26
🟡 Moderate
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
7,216
Total Claims
$320K
Drug Cost
548
Beneficiaries
$584
Cost/Patient
Risk Score Breakdown 26/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,498 Interventional Pain Management providers
+55%
Opioid rate vs peers
71.2% vs 45.9% avg
+21%
Cost per patient vs peers
$584 vs $483 avg
-30%
Brand preference vs peers
2.9% vs 4.1% 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
71.2%
Opioid Rate
5,138
Opioid Claims
$254K
Opioid Cost
13.4%
Long-Acting Rate
This provider's opioid prescribing rate of 71.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 209 claims · $110K
Generic: 7,007 claims · $210K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 129 | $99K |
| Hydrocodone/Acetaminophen | 1,840 | $58K |
| Oxycodone Hcl/Acetaminophen | 923 | $41K |
| Oxycodone Hcl | 1,155 | $29K |
| Pregabalin | 192 | $15K |
| Gabapentin | 568 | $12K |
| Morphine Sulfate | 279 | $8,990 |
| Tramadol Hcl | 411 | $7,052 |
| Naloxegol Oxalate | 11 | $4,656 |
| Fentanyl | 82 | $4,551 |
| Tizanidine Hcl | 182 | $3,787 |
| Methadone Hcl | 196 | $3,720 |
| Diclofenac Sodium | 47 | $2,605 |
| Naloxone Hcl | 24 | $1,998 |
| Hydromorphone Hcl | 106 | $1,964 |
Prescribing Profile
38
Unique Drugs
26.0
Anomaly Score
Patient Profile
68
Avg Age
56%
Female
1.50
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