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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.

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James JacksonMD

Pain Management · Louisville, KY 40207

NPI: 1063583268

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29

🟡 Moderate

Risk Flags

High opioid rate vs specialty peers99th percentile opioid prescribing

Risk indicators are statistical patterns, not allegations. Learn more

9,948

Total Claims

$392K

Drug Cost

1,606

Beneficiaries

$244

Cost/Patient

Risk Score Breakdown 29/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate (national percentile)+15
Opioid rate vs specialty peers+10

Score components are additive. Read full methodology

Peer Comparison vs. 2,621 Pain Management providers

+112%

Opioid rate vs peers

87.2% vs 41.3% avg

-39%

Cost per patient vs peers

$244 vs $399 avg

-64%

Brand preference vs peers

1.3% vs 3.8% avg

Opioid Prescribing

87.2%

Opioid Rate

8,679

Opioid Claims

$358K

Opioid Cost

4.2%

Long-Acting Rate

This provider's opioid prescribing rate of 87.2% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

99% generic

Brand: 133 claims · $100K

Generic: 9,815 claims · $292K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Oxycodone Hcl/Acetaminophen3,096$117K
Hydrocodone/Acetaminophen4,321$109K
Oxycodone Hcl64$77K
Oxycodone Myristate16$18K
Oxycodone Hcl680$17K
Gabapentin871$14K
Fentanyl57$10K
Pregabalin132$8,757
Morphine Sulfate130$4,111
Methadone Hcl99$1,741
Tramadol Hcl114$1,329
Ondansetron16$1,031
Celecoxib18$563
Morphine Sulfate35$553
Tizanidine Hcl36$472

Prescribing Profile

21

Unique Drugs

29.0

Anomaly Score

Patient Profile

66

Avg Age

63%

Female

1.59

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