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
9,986
Total Claims
$540K
Drug Cost
682
Beneficiaries
$792
Cost/Patient
Risk Score Breakdown 59/100
Score components are additive. Read full methodology
Peer Comparison vs. 44,021 Emergency Medicine providers
+496%
Opioid rate vs peers
56.1% vs 9.4% avg
+200%
Brand preference vs peers
4.5% vs 1.5% 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 rate is 496% above Emergency Medicine 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.
Composite risk score of 59/100 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
56.1%
Opioid Rate
5,604
Opioid Claims
$338K
Opioid Cost
11.9%
Long-Acting Rate
This provider's opioid prescribing rate of 56.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 445 claims · $289K
Generic: 9,541 claims · $251K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 140 | $96K |
| Hydrocodone/Acetaminophen | 2,564 | $66K |
| Methylnaltrexone Bromide | 26 | $66K |
| Oxycodone Hcl/Acetaminophen | 1,782 | $55K |
| Oxycodone Hcl | 83 | $52K |
| Buprenorphine Hcl/Naloxone Hcl | 129 | $30K |
| Buprenorphine | 89 | $25K |
| Naloxegol Oxalate | 43 | $18K |
| Buprenorphine Hcl/Naloxone Hcl | 12 | $17K |
| Gabapentin | 922 | $11K |
| Buprenorphine Hcl | 17 | $9,604 |
| Oxycodone Hcl | 470 | $9,410 |
| Linaclotide | 16 | $9,250 |
| Tizanidine Hcl | 790 | $8,379 |
| Morphine Sulfate | 252 | $6,512 |
Prescribing Profile
50
Unique Drugs
59.0
Anomaly Score
Patient Profile
63
Avg Age
58%
Female
1.61
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