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
5,582
Total Claims
$300K
Drug Cost
755
Beneficiaries
$397
Cost/Patient
Risk Score Breakdown 26/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,621 Pain Management providers
+70%
Opioid rate vs peers
70.0% vs 41.3% avg
0%
Cost per patient vs peers
$397 vs $399 avg
+12%
Brand preference vs peers
4.2% vs 3.8% 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
70.0%
Opioid Rate
3,905
Opioid Claims
$256K
Opioid Cost
14.7%
Long-Acting Rate
This provider's opioid prescribing rate of 70.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 234 claims · $143K
Generic: 5,348 claims · $157K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 65 | $56K |
| Hydrocodone/Acetaminophen | 2,106 | $50K |
| Oxycodone Hcl | 39 | $50K |
| Oxycodone Hcl/Acetaminophen | 12 | $34K |
| Fentanyl | 131 | $12K |
| Buprenorphine | 19 | $8,575 |
| Oxycodone Hcl/Acetaminophen | 368 | $7,673 |
| Gabapentin | 448 | $6,551 |
| Oxycodone Hcl | 261 | $5,448 |
| Pregabalin | 226 | $5,261 |
| Naloxegol Oxalate | 11 | $4,529 |
| Morphine Sulfate | 125 | $4,405 |
| Methadone Hcl | 168 | $2,978 |
| Tizanidine Hcl | 196 | $2,803 |
| Tramadol Hcl | 360 | $2,753 |
Prescribing Profile
33
Unique Drugs
26.0
Anomaly Score
Patient Profile
73
Avg Age
60%
Female
1.69
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