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 →41
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
5,422
Total Claims
$375K
Drug Cost
467
Beneficiaries
$803
Cost/Patient
Risk Score Breakdown 41/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+494%
Opioid rate vs peers
54.6% vs 9.2% avg
+12%
Cost per patient vs peers
$803 vs $719 avg
+14%
Brand preference vs peers
7.6% 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 rate is 494% above Physician Assistant peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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
54.6%
Opioid Rate
2,958
Opioid Claims
$214K
Opioid Cost
16.4%
Long-Acting Rate
This provider's opioid prescribing rate of 54.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 412 claims · $196K
Generic: 5,010 claims · $180K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl | 81 | $64K |
| Buprenorphine | 63 | $28K |
| Hydrocodone/Acetaminophen | 846 | $23K |
| Oxycodone Hcl | 37 | $22K |
| Naloxegol Oxalate | 31 | $21K |
| Gabapentin | 746 | $20K |
| Lidocaine | 95 | $19K |
| Oxycodone Hcl/Acetaminophen | 640 | $17K |
| Pregabalin | 269 | $16K |
| Hydrocodone Bitartrate | 18 | $16K |
| Diclofenac Sodium | 206 | $12K |
| Oxycodone Hcl | 521 | $12K |
| Gabapentin Enacarbil | 11 | $11K |
| Lidocaine | 14 | $10K |
| Lubiprostone | 24 | $7,747 |
Prescribing Profile
34
Unique Drugs
41.0
Anomaly Score
Patient Profile
71
Avg Age
68%
Female
1.41
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