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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 →

Edward Albert BalbasM.D.

Physical Medicine and Rehabilitation · Colton, CA 92324

NPI: 1629062435

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38

🟠 Elevated

🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)

Exclusion type: 1128a3 · Date: 20240418 · State: CA

Risk Flags

95th percentile opioid prescribingHigh long-acting opioid rate vs peersOIG Excluded Provider

Risk indicators are statistical patterns, not allegations. Learn more

216

Total Claims

$24K

Drug Cost

19

Beneficiaries

$1,254

Cost/Patient

Risk Score Breakdown 38/100

Low (0)Moderate (15)Elevated (30)High (50+)
OIG excluded provider+20
Opioid rate (national percentile)+10
Long-acting opioid rate+8

Score components are additive. Read full methodology

Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers

+147%

Opioid rate vs peers

50.0% vs 20.2% avg

+175%

Cost per patient vs peers

$1,254 vs $455 avg

Opioid Prescribing

50.0%

Opioid Rate

108

Opioid Claims

$18K

Opioid Cost

41.7%

Long-Acting Rate

This provider's opioid prescribing rate of 50.0% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

100% generic

Brand: 0 claims · $0

Generic: 206 claims · $20K

Patient Profile

63

Avg Age

Female

1.67

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