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
11,819
Total Claims
$793K
Drug Cost
1,622
Beneficiaries
$489
Cost/Patient
Risk Score Breakdown 55/100
Score components are additive. Read full methodology
Peer Comparison vs. 350 Addiction Medicine providers
+1647%
Opioid rate vs peers
75.5% vs 4.3% avg
-65%
Cost per patient vs peers
$489 vs $1,415 avg
-10%
Brand preference vs peers
7.3% vs 8.1% 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 1,647% above the average for Addiction Medicine 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 55/100 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
75.5%
Opioid Rate
8,929
Opioid Claims
$658K
Opioid Cost
19.9%
Long-Acting Rate
This provider's opioid prescribing rate of 75.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 861 claims · $366K
Generic: 10,958 claims · $428K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 4,151 | $113K |
| Buprenorphine Hcl | 138 | $110K |
| Oxycodone Hcl/Acetaminophen | 1,888 | $107K |
| Buprenorphine | 250 | $85K |
| Oxycodone Myristate | 120 | $52K |
| Oxycodone Hcl | 127 | $51K |
| Buprenorphine | 44 | $27K |
| Tapentadol Hcl | 25 | $23K |
| Buprenorphine Hcl | 219 | $16K |
| Hydrocodone Bitartrate | 37 | $16K |
| Pregabalin | 450 | $16K |
| Morphine Sulfate | 764 | $14K |
| Fentanyl | 113 | $13K |
| Naloxegol Oxalate | 31 | $13K |
| Buprenorphine Hcl/Naloxone Hcl | 43 | $12K |
Prescribing Profile
48
Unique Drugs
55.0
Anomaly Score
Patient Profile
67
Avg Age
66%
Female
1.85
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