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 →47
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
7,781
Total Claims
$374K
Drug Cost
828
Beneficiaries
$451
Cost/Patient
Risk Score Breakdown 47/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+347%
Opioid rate vs peers
90.4% vs 20.2% avg
-1%
Cost per patient vs peers
$451 vs $455 avg
+87%
Brand preference vs peers
5.9% vs 3.1% 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 rate is 347% 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
90.4%
Opioid Rate
7,032
Opioid Claims
$331K
Opioid Cost
10.6%
Long-Acting Rate
This provider's opioid prescribing rate of 90.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 458 claims · $123K
Generic: 7,323 claims · $251K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 2,996 | $102K |
| Oxycodone Hcl/Acetaminophen | 1,749 | $70K |
| Oxycodone Hcl | 82 | $34K |
| Oxycodone Myristate | 57 | $26K |
| Buprenorphine Hcl | 29 | $24K |
| Oxycodone Hcl | 850 | $18K |
| Naloxone Hcl | 153 | $13K |
| Buprenorphine | 33 | $12K |
| Morphine Sulfate | 453 | $11K |
| Hydrocodone Bitartrate | 19 | $9,075 |
| Hydromorphone Hcl | 431 | $7,222 |
| Fentanyl | 35 | $6,863 |
| Morphine Sulfate | 159 | $4,911 |
| Buprenorphine Hcl | 78 | $2,831 |
| Gabapentin | 88 | $1,902 |
Prescribing Profile
22
Unique Drugs
47.0
Anomaly Score
Patient Profile
68
Avg Age
63%
Female
1.89
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