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
10,074
Total Claims
$895K
Drug Cost
1,349
Beneficiaries
$663
Cost/Patient
Risk Score Breakdown 51/100
Score components are additive. Read full methodology
Peer Comparison vs. 109,535 Physician Assistant providers
+621%
Opioid rate vs peers
66.3% vs 9.2% avg
-8%
Cost per patient vs peers
$663 vs $719 avg
+18%
Brand preference vs peers
7.9% vs 6.7% 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 621% above the average for Physician Assistant 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 51/100 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
66.3%
Opioid Rate
6,679
Opioid Claims
$575K
Opioid Cost
16.8%
Long-Acting Rate
This provider's opioid prescribing rate of 66.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 792 claims · $543K
Generic: 9,282 claims · $352K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 135 | $93K |
| Buprenorphine Hcl | 103 | $87K |
| Oxycodone Hcl | 74 | $78K |
| Hydrocodone/Acetaminophen | 2,006 | $74K |
| Oxycodone Hcl | 2,028 | $66K |
| Oxycodone Hcl/Acetaminophen | 905 | $41K |
| Ubrogepant | 28 | $37K |
| Rimegepant Sulfate | 21 | $32K |
| Buprenorphine | 69 | $25K |
| Naloxegol Oxalate | 54 | $23K |
| Gabapentin | 887 | $22K |
| Erenumab-Aooe | 17 | $19K |
| Fentanyl | 194 | $18K |
| Buprenorphine | 17 | $15K |
| Pregabalin | 264 | $13K |
Prescribing Profile
49
Unique Drugs
51.0
Anomaly Score
Patient Profile
64
Avg Age
66%
Female
1.69
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