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
11,105
Total Claims
$638K
Drug Cost
1,212
Beneficiaries
$526
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+282%
Opioid rate vs peers
77.2% vs 20.2% avg
+16%
Cost per patient vs peers
$526 vs $455 avg
+141%
Brand preference vs peers
7.6% vs 3.1% 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 rate is 282% 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
77.2%
Opioid Rate
8,574
Opioid Claims
$560K
Opioid Cost
23.9%
Long-Acting Rate
This provider's opioid prescribing rate of 77.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 842 claims · $372K
Generic: 10,263 claims · $266K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 436 | $192K |
| Hydrocodone/Acetaminophen | 4,198 | $116K |
| Buprenorphine Hcl | 96 | $47K |
| Oxycodone Hcl/Acetaminophen | 1,582 | $43K |
| Oxycodone Hcl | 57 | $41K |
| Buprenorphine | 100 | $29K |
| Hydrocodone Bitartrate | 61 | $26K |
| Morphine Sulfate | 1,013 | $19K |
| Naloxegol Oxalate | 34 | $15K |
| Fentanyl | 153 | $12K |
| Oxycodone Hcl | 445 | $8,278 |
| Gabapentin | 550 | $7,543 |
| Naloxone Hcl | 81 | $7,371 |
| Hydrocodone Bitartrate | 22 | $4,947 |
| Tizanidine Hcl | 397 | $4,673 |
Prescribing Profile
46
Unique Drugs
38.0
Anomaly Score
Patient Profile
68
Avg Age
66%
Female
1.71
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