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
9,061
Total Claims
$839K
Drug Cost
1,019
Beneficiaries
$824
Cost/Patient
Risk Score Breakdown 64/100
Score components are additive. Read full methodology
Peer Comparison vs. 106,889 Family Practice providers
+2129%
Opioid rate vs peers
57.5% vs 2.6% avg
-23%
Cost per patient vs peers
$824 vs $1,068 avg
+40%
Brand preference vs peers
12.6% vs 9.0% 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 2,129% 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 64/100 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
57.5%
Opioid Rate
5,209
Opioid Claims
$609K
Opioid Cost
24.8%
Long-Acting Rate
This provider's opioid prescribing rate of 57.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,138 claims · $553K
Generic: 7,903 claims · $286K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Buprenorphine Hcl | 155 | $136K |
| Buprenorphine | 235 | $85K |
| Oxycodone Myristate | 154 | $76K |
| Apixaban | 212 | $65K |
| Oxycodone Hcl | 92 | $62K |
| Hydrocodone Bitartrate | 90 | $60K |
| Hydrocodone/Acetaminophen | 1,804 | $50K |
| Oxycodone Hcl/Acetaminophen | 677 | $23K |
| Hydromorphone Hcl | 79 | $20K |
| Tapentadol Hcl | 21 | $18K |
| Pregabalin | 263 | $18K |
| Hydrocodone Bitartrate | 36 | $15K |
| Tapentadol Hcl | 15 | $13K |
| Oxycodone Hcl | 663 | $12K |
| Tiotropium Bromide | 18 | $11K |
Prescribing Profile
Patient Profile
73
Avg Age
60%
Female
1.92
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