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
6,877
Total Claims
$325K
Drug Cost
889
Beneficiaries
$365
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 2,621 Pain Management providers
+47%
Opioid rate vs peers
60.8% vs 41.3% avg
-8%
Cost per patient vs peers
$365 vs $399 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
60.8%
Opioid Rate
4,180
Opioid Claims
$256K
Opioid Cost
17.2%
Long-Acting Rate
This provider's opioid prescribing rate of 60.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 6,644 claims · $201K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 75 | $69K |
| Hydrocodone/Acetaminophen | 1,411 | $39K |
| Oxycodone Hcl/Acetaminophen | 1,070 | $32K |
| Fentanyl | 172 | $25K |
| Oxycodone Hcl | 465 | $15K |
| Oxycodone Myristate | 14 | $14K |
| Pregabalin | 217 | $11K |
| Gabapentin | 710 | $11K |
| Morphine Sulfate | 218 | $7,275 |
| Lidocaine | 46 | $7,081 |
| Tizanidine Hcl | 386 | $5,762 |
| Methadone Hcl | 218 | $5,067 |
| Celecoxib | 49 | $3,996 |
| Tramadol Hcl | 406 | $3,048 |
| Cyclobenzaprine Hcl | 191 | $2,202 |
Prescribing Profile
32
Unique Drugs
21.0
Anomaly Score
Patient Profile
70
Avg Age
62%
Female
1.55
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