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 →40
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
19,186
Total Claims
$5.1M
Drug Cost
813
Beneficiaries
$6,315
Cost/Patient
Risk Score Breakdown 40/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+150%
Opioid rate vs peers
50.6% vs 20.2% avg
+1287%
Cost per patient vs peers
$6,315 vs $455 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
Cost per patient is 1287% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
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
50.6%
Opioid Rate
9,710
Opioid Claims
$3.3M
Opioid Cost
42.1%
Long-Acting Rate
This provider's opioid prescribing rate of 50.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 14,965 claims · $762K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl | 1,575 | $1.5M |
| Tapentadol Hcl | 428 | $602K |
| Tapentadol Hcl | 226 | $415K |
| Abaloparatide | 145 | $405K |
| Gabapentin Enacarbil | 357 | $381K |
| Buprenorphine | 715 | $292K |
| Gabapentin | 114 | $155K |
| Buprenorphine | 168 | $153K |
| Teriparatide | 28 | $127K |
| Methylnaltrexone Bromide | 51 | $122K |
| Tramadol Hcl | 817 | $78K |
| Hydrocodone/Acetaminophen | 2,575 | $72K |
| Oxycodone Myristate | 88 | $65K |
| Naloxegol Oxalate | 98 | $49K |
| Diclofenac Potassium | 321 | $44K |
Prescribing Profile
95
Unique Drugs
40.0
Anomaly Score
Patient Profile
64
Avg Age
59%
Female
2.00
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