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
5,355
Total Claims
$986K
Drug Cost
915
Beneficiaries
$1,077
Cost/Patient
Risk Score Breakdown 64/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,389 General Practice providers
+2704%
Opioid rate vs peers
69.4% vs 2.5% avg
-4%
Cost per patient vs peers
$1,077 vs $1,128 avg
+77%
Brand preference vs peers
14.9% vs 8.4% 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 2,704% above the average for General 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
69.4%
Opioid Rate
3,717
Opioid Claims
$813K
Opioid Cost
36.9%
Long-Acting Rate
This provider's opioid prescribing rate of 69.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 798 claims · $700K
Generic: 4,557 claims · $286K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 345 | $333K |
| Oxycodone Hcl | 188 | $185K |
| Oxymorphone Hcl | 68 | $60K |
| Oxycodone Hcl/Acetaminophen | 652 | $57K |
| Hydrocodone Bitartrate | 27 | $33K |
| Oxycodone Hcl | 1,256 | $32K |
| Methylnaltrexone Bromide | 12 | $30K |
| Naloxegol Oxalate | 55 | $23K |
| Morphine Sulfate | 463 | $18K |
| Fentanyl | 146 | $17K |
| Lidocaine | 34 | $13K |
| Linaclotide | 19 | $10K |
| Hydrocodone/Acetaminophen | 339 | $9,669 |
| Erenumab-Aooe | 12 | $9,455 |
| Naloxone Hcl | 107 | $9,033 |
Prescribing Profile
36
Unique Drugs
64.0
Anomaly Score
Patient Profile
64
Avg Age
64%
Female
1.70
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