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 →Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
6,117
Total Claims
$569K
Drug Cost
619
Beneficiaries
$919
Cost/Patient
Risk Score Breakdown 51/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+577%
Opioid rate vs peers
62.2% vs 9.2% avg
+28%
Cost per patient vs peers
$919 vs $719 avg
+44%
Brand preference vs peers
9.6% vs 6.7% 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 prescribing rate is 577% above the average for Physician Assistant providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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.
Composite risk score of 51/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
62.2%
Opioid Rate
3,805
Opioid Claims
$434K
Opioid Cost
15.6%
Long-Acting Rate
This provider's opioid prescribing rate of 62.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 585 claims · $365K
Generic: 5,532 claims · $204K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 179 | $134K |
| Tapentadol Hcl | 59 | $81K |
| Oxycodone Hcl/Acetaminophen | 12 | $53K |
| Methylnaltrexone Bromide | 12 | $29K |
| Hydrocodone/Acetaminophen | 1,032 | $28K |
| Tapentadol Hcl | 14 | $25K |
| Oxycodone Hcl/Acetaminophen | 827 | $23K |
| Naloxegol Oxalate | 36 | $20K |
| Buprenorphine Hcl | 21 | $19K |
| Oxycodone Hcl | 611 | $15K |
| Gabapentin | 587 | $11K |
| Morphine Sulfate | 184 | $9,406 |
| Linaclotide | 11 | $8,401 |
| Oxycodone Hcl | 15 | $8,260 |
| Lubiprostone | 17 | $7,049 |
Prescribing Profile
38
Unique Drugs
51.0
Anomaly Score
Patient Profile
70
Avg Age
61%
Female
1.64
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 of wrongdoing.Methodology · About · Dispute this data