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 →38
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
5,531
Total Claims
$337K
Drug Cost
442
Beneficiaries
$762
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+335%
Opioid rate vs peers
87.9% vs 20.2% avg
+67%
Cost per patient vs peers
$762 vs $455 avg
+44%
Brand preference vs peers
4.5% vs 3.1% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid rate is 335% above Physical Medicine and Rehabilitation peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
87.9%
Opioid Rate
4,864
Opioid Claims
$292K
Opioid Cost
13.4%
Long-Acting Rate
This provider's opioid prescribing rate of 87.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 251 claims · $138K
Generic: 5,280 claims · $199K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine | 156 | $61K |
| Oxycodone Hcl/Acetaminophen | 1,643 | $56K |
| Tapentadol Hcl | 27 | $50K |
| Hydrocodone/Acetaminophen | 1,496 | $42K |
| Tapentadol Hcl | 27 | $20K |
| Buprenorphine Hcl | 21 | $9,875 |
| Oxymorphone Hcl | 12 | $7,436 |
| Oxycodone Hcl | 24 | $7,333 |
| Pregabalin | 277 | $7,293 |
| Naloxegol Oxalate | 13 | $7,186 |
| Oxycodone Hcl | 362 | $6,874 |
| Fentanyl | 82 | $6,629 |
| Morphine Sulfate | 270 | $6,565 |
| Buprenorphine | 12 | $4,989 |
| Tramadol Hcl | 483 | $4,027 |
Prescribing Profile
22
Unique Drugs
38.0
Anomaly Score
Patient Profile
66
Avg Age
68%
Female
1.83
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