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 →25
🟡 Moderate
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
78
Total Claims
$65K
Drug Cost
16
Beneficiaries
$4,037
Cost/Patient
Risk Score Breakdown 25/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,404 Physical Medicine and Rehabilitation providers
+319%
Opioid rate vs peers
84.6% vs 20.2% avg
+786%
Cost per patient vs peers
$4,037 vs $455 avg
+390%
Brand preference vs peers
15.4% vs 3.1% avg
🔎 Data Overview
Opioid rate is 319% above Physical Medicine and Rehabilitation peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Cost per patient is 786% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
84.6%
Opioid Rate
66
Opioid Claims
$65K
Opioid Cost
18.2%
Long-Acting Rate
This provider's opioid prescribing rate of 84.6% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 12 claims · $64K
Generic: 66 claims · $985
Patient Profile
71
Avg Age
—
Female
1.34
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