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
18,978
Total Claims
$680K
Drug Cost
2,568
Beneficiaries
$265
Cost/Patient
Risk Score Breakdown 49/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+2607%
Opioid rate vs peers
60.6% vs 2.2% avg
-81%
Cost per patient vs peers
$265 vs $1,411 avg
-86%
Brand preference vs peers
1.5% vs 10.6% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ 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 2,607% above the average for Internal Medicine 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
60.6%
Opioid Rate
11,500
Opioid Claims
$482K
Opioid Cost
11.9%
Long-Acting Rate
This provider's opioid prescribing rate of 60.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 292 claims · $155K
Generic: 18,686 claims · $524K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 4,820 | $131K |
| Oxycodone Hcl/Acetaminophen | 3,530 | $126K |
| Gabapentin | 5,772 | $102K |
| Oxycodone Myristate | 93 | $62K |
| Oxycodone Hcl | 93 | $52K |
| Pregabalin | 687 | $42K |
| Oxycodone Hcl | 1,389 | $36K |
| Fentanyl | 166 | $23K |
| Oxymorphone Hcl | 52 | $17K |
| Gabapentin | 12 | $17K |
| Morphine Sulfate | 626 | $14K |
| Methadone Hcl | 325 | $7,428 |
| Diclofenac Sodium | 82 | $3,367 |
| Tizanidine Hcl | 174 | $3,023 |
| Tramadol Hcl | 240 | $2,783 |
Prescribing Profile
33
Unique Drugs
49.0
Anomaly Score
Patient Profile
65
Avg Age
59%
Female
1.75
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