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 →21
🟡 Moderate
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
14,228
Total Claims
$907K
Drug Cost
1,115
Beneficiaries
$813
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+217%
Opioid rate vs peers
64.0% vs 20.2% avg
+79%
Cost per patient vs peers
$813 vs $455 avg
+17%
Brand preference vs peers
3.7% vs 3.1% 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
Opioid rate is 217% above Physical Medicine and Rehabilitation 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
64.0%
Opioid Rate
9,108
Opioid Claims
$614K
Opioid Cost
9.5%
Long-Acting Rate
This provider's opioid prescribing rate of 64.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 522 claims · $331K
Generic: 13,706 claims · $576K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl/Acetaminophen | 1,773 | $125K |
| Oxycodone Hcl/Acetaminophen | 47 | $120K |
| Hydrocodone/Acetaminophen | 4,716 | $112K |
| Oxycodone Hcl | 83 | $81K |
| Buprenorphine Hcl/Naloxone Hcl | 90 | $80K |
| Oxycodone Myristate | 92 | $78K |
| Buprenorphine Hcl/Naloxone Hcl | 214 | $69K |
| Buprenorphine Hcl/Naloxone Hcl | 41 | $32K |
| Oxycodone Hcl | 1,108 | $26K |
| Pregabalin | 593 | $20K |
| Gabapentin | 1,089 | $15K |
| Morphine Sulfate | 460 | $15K |
| Tapentadol Hcl | 12 | $15K |
| Linaclotide | 15 | $12K |
| Fentanyl | 98 | $9,952 |
Prescribing Profile
49
Unique Drugs
21.0
Anomaly Score
Patient Profile
64
Avg Age
60%
Female
1.69
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About