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 →21
🟡 Moderate
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
6,354
Total Claims
$331K
Drug Cost
618
Beneficiaries
$536
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+207%
Opioid rate vs peers
62.0% vs 20.2% avg
+18%
Cost per patient vs peers
$536 vs $455 avg
+65%
Brand preference vs peers
5.2% vs 3.1% 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
Opioid rate is 207% above Physical Medicine and Rehabilitation 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.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
62.0%
Opioid Rate
3,942
Opioid Claims
$247K
Opioid Cost
18.9%
Long-Acting Rate
This provider's opioid prescribing rate of 62.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 329 claims · $160K
Generic: 6,025 claims · $171K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 136 | $94K |
| Oxycodone Hcl/Acetaminophen | 1,019 | $50K |
| Hydrocodone/Acetaminophen | 793 | $26K |
| Oxycodone Hcl | 929 | $21K |
| Naloxegol Oxalate | 42 | $17K |
| Tapentadol Hcl | 12 | $15K |
| Morphine Sulfate | 512 | $12K |
| Oxycodone Hcl | 24 | $11K |
| Pregabalin | 11 | $10K |
| Gabapentin | 584 | $9,980 |
| Pregabalin | 223 | $8,773 |
| Linaclotide | 12 | $6,693 |
| Tizanidine Hcl | 436 | $5,650 |
| Lidocaine | 32 | $4,716 |
| Buprenorphine | 14 | $3,954 |
Prescribing Profile
34
Unique Drugs
21.0
Anomaly Score
Patient Profile
70
Avg Age
60%
Female
1.82
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