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
10,691
Total Claims
$565K
Drug Cost
706
Beneficiaries
$801
Cost/Patient
Risk Score Breakdown 40/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+2399%
Opioid rate vs peers
64.4% vs 2.6% avg
-25%
Cost per patient vs peers
$801 vs $1,068 avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid prescribing rate is 2,399% above the average for Family Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
64.4%
Opioid Rate
6,889
Opioid Claims
$246K
Opioid Cost
6.6%
Long-Acting Rate
This provider's opioid prescribing rate of 64.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 10,247 claims · $322K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 4,676 | $167K |
| Methylnaltrexone Bromide | 61 | $156K |
| Naloxegol Oxalate | 60 | $36K |
| Lidocaine | 227 | $26K |
| Gabapentin | 1,351 | $24K |
| Oxycodone Hcl/Acetaminophen | 539 | $19K |
| Milnacipran Hcl | 37 | $18K |
| Buprenorphine | 43 | $17K |
| Pregabalin | 654 | $15K |
| Oxycodone Hcl | 509 | $9,329 |
| Linaclotide | 16 | $8,820 |
| Oxycodone Hcl | 26 | $8,056 |
| Lidocaine/Prilocaine | 88 | $7,096 |
| Duloxetine Hcl | 463 | $6,092 |
| Morphine Sulfate | 224 | $5,554 |
Prescribing Profile
32
Unique Drugs
40.0
Anomaly Score
Patient Profile
65
Avg Age
57%
Female
1.63
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