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 →35
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
2,734
Total Claims
$673K
Drug Cost
148
Beneficiaries
$4,551
Cost/Patient
Risk Score Breakdown 35/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+271%
Opioid rate vs peers
74.9% vs 20.2% avg
+899%
Cost per patient vs peers
$4,551 vs $455 avg
+627%
Brand preference vs peers
22.9% vs 3.1% avg
🔎 Data Overview
Opioid rate is 271% above Physical Medicine and Rehabilitation peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Cost per patient is 899% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
74.9%
Opioid Rate
2,049
Opioid Claims
$583K
Opioid Cost
42.2%
Long-Acting Rate
This provider's opioid prescribing rate of 74.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 625 claims · $451K
Generic: 2,109 claims · $222K
Patient Profile
65
Avg Age
51%
Female
1.74
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About