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
🤖 ML Fraud Detection Score: 86%
Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
5,308
Total Claims
$440K
Drug Cost
341
Beneficiaries
$1,290
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+236%
Opioid rate vs peers
67.8% vs 20.2% avg
+183%
Cost per patient vs peers
$1,290 vs $455 avg
+142%
Brand preference vs peers
7.6% 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.
Opioid Prescribing
67.8%
Opioid Rate
3,599
Opioid Claims
$414K
Opioid Cost
23.5%
Long-Acting Rate
This provider's opioid prescribing rate of 67.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 403 claims · $288K
Generic: 4,905 claims · $152K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 163 | $134K |
| Oxycodone Hcl | 88 | $84K |
| Buprenorphine Hcl | 82 | $53K |
| Oxycodone Hcl/Acetaminophen | 1,056 | $33K |
| Hydrocodone/Acetaminophen | 866 | $22K |
| Oxymorphone Hcl | 24 | $16K |
| Oxycodone Hcl | 631 | $14K |
| Tapentadol Hcl | 14 | $13K |
| Gabapentin | 559 | $9,593 |
| Fentanyl | 84 | $9,517 |
| Buprenorphine | 29 | $8,518 |
| Morphine Sulfate | 225 | $5,866 |
| Pregabalin | 162 | $4,922 |
| Tizanidine Hcl | 249 | $2,943 |
| Cyclobenzaprine Hcl | 270 | $2,545 |
Prescribing Profile
26
Unique Drugs
38.0
Anomaly Score
Patient Profile
67
Avg Age
60%
Female
2.03
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