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 →38
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
15,225
Total Claims
$932K
Drug Cost
1,080
Beneficiaries
$863
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+294%
Opioid rate vs peers
79.7% vs 20.2% avg
+90%
Cost per patient vs peers
$863 vs $455 avg
+112%
Brand preference vs peers
6.7% 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 294% 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
79.7%
Opioid Rate
12,134
Opioid Claims
$841K
Opioid Cost
15.9%
Long-Acting Rate
This provider's opioid prescribing rate of 79.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,013 claims · $439K
Generic: 14,212 claims · $494K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 217 | $164K |
| Oxycodone Myristate | 133 | $129K |
| Oxycodone Hcl | 4,221 | $114K |
| Oxycodone Hcl/Acetaminophen | 2,788 | $88K |
| Tapentadol Hcl | 44 | $67K |
| Fentanyl | 497 | $52K |
| Hydrocodone/Acetaminophen | 1,717 | $43K |
| Buprenorphine Hcl | 38 | $35K |
| Oxycodone Hcl/Acetaminophen | 13 | $30K |
| Oxymorphone Hcl | 17 | $21K |
| Hydromorphone Hcl | 50 | $20K |
| Morphine Sulfate | 473 | $20K |
| Hydromorphone Hcl | 745 | $15K |
| Naloxegol Oxalate | 19 | $11K |
| Gabapentin | 544 | $11K |
Prescribing Profile
46
Unique Drugs
38.0
Anomaly Score
Patient Profile
66
Avg Age
61%
Female
2.08
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