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
5,435
Total Claims
$340K
Drug Cost
569
Beneficiaries
$597
Cost/Patient
Risk Score Breakdown 54/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+2301%
Opioid rate vs peers
61.9% vs 2.6% avg
-44%
Cost per patient vs peers
$597 vs $1,068 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 2,301% above the average for Family Practice 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 54/100 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
61.9%
Opioid Rate
3,365
Opioid Claims
$266K
Opioid Cost
20.0%
Long-Acting Rate
This provider's opioid prescribing rate of 61.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 5,173 claims · $172K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 67 | $95K |
| Hydrocodone/Acetaminophen | 1,141 | $37K |
| Oxycodone Myristate | 34 | $29K |
| Oxycodone Hcl | 893 | $24K |
| Oxycodone Hcl/Acetaminophen | 401 | $22K |
| Morphine Sulfate | 456 | $22K |
| Naloxegol Oxalate | 19 | $15K |
| Fentanyl | 61 | $11K |
| Buprenorphine | 13 | $5,380 |
| Buprenorphine Hcl/Naloxone Hcl | 15 | $5,047 |
| Morphine Sulfate | 69 | $3,466 |
| Pregabalin | 104 | $3,210 |
| Gabapentin | 126 | $2,141 |
| Tizanidine Hcl | 259 | $2,136 |
| Hydromorphone Hcl | 63 | $2,041 |
Prescribing Profile
56
Unique Drugs
54.0
Anomaly Score
Patient Profile
69
Avg Age
63%
Female
2.13
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