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
5,092
Total Claims
$975K
Drug Cost
493
Beneficiaries
$1,978
Cost/Patient
Risk Score Breakdown 41/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+515%
Opioid rate vs peers
56.5% vs 9.2% avg
+175%
Cost per patient vs peers
$1,978 vs $719 avg
+173%
Brand preference vs peers
18.1% vs 6.7% 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 prescribing rate is 515% above the average for Physician Assistant providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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
56.5%
Opioid Rate
2,879
Opioid Claims
$568K
Opioid Cost
24.2%
Long-Acting Rate
This provider's opioid prescribing rate of 56.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 924 claims · $710K
Generic: 4,168 claims · $266K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl | 148 | $133K |
| Tapentadol Hcl | 53 | $91K |
| Oxycodone Hcl/Acetaminophen | 503 | $81K |
| Oxycodone Myristate | 76 | $71K |
| Methylnaltrexone Bromide | 19 | $47K |
| Galcanezumab-Gnlm | 53 | $44K |
| Oxycodone Hcl | 56 | $39K |
| Tapentadol Hcl | 26 | $38K |
| Lidocaine | 57 | $37K |
| Rimegepant Sulfate | 36 | $36K |
| Naloxegol Oxalate | 86 | $36K |
| Diclofenac Sodium | 82 | $30K |
| Ubrogepant | 33 | $30K |
| Buprenorphine | 60 | $24K |
| Hydrocodone/Acetaminophen | 731 | $24K |
Prescribing Profile
51
Unique Drugs
41.0
Anomaly Score
Patient Profile
67
Avg Age
67%
Female
1.83
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