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
7,136
Total Claims
$415K
Drug Cost
539
Beneficiaries
$770
Cost/Patient
Risk Score Breakdown 41/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+533%
Opioid rate vs peers
58.2% vs 9.2% avg
+7%
Cost per patient vs peers
$770 vs $719 avg
-28%
Brand preference vs peers
4.8% vs 6.7% 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
Opioid prescribing rate is 533% above the average for Physician Assistant providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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
58.2%
Opioid Rate
4,154
Opioid Claims
$257K
Opioid Cost
22.5%
Long-Acting Rate
This provider's opioid prescribing rate of 58.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 342 claims · $221K
Generic: 6,794 claims · $194K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 1,182 | $39K |
| Buprenorphine Hcl | 44 | $38K |
| Buprenorphine | 103 | $36K |
| Rimegepant Sulfate | 30 | $34K |
| Erenumab-Aooe | 28 | $28K |
| Oxycodone Hcl | 974 | $23K |
| Oxycodone Hcl | 44 | $18K |
| Oxycodone Myristate | 30 | $16K |
| Oxycodone Hcl/Acetaminophen | 462 | $16K |
| Gabapentin | 564 | $12K |
| Morphine Sulfate | 407 | $12K |
| Pregabalin | 350 | $7,213 |
| Naloxegol Oxalate | 17 | $7,071 |
| Fentanyl | 74 | $6,220 |
| Linaclotide | 11 | $6,190 |
Prescribing Profile
51
Unique Drugs
41.0
Anomaly Score
Patient Profile
68
Avg Age
72%
Female
1.40
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