diff --git a/db/migrate/20260316093605_add_cvd_risk_score_to_reporting_patient_prescriptions.rb b/db/migrate/20260316093605_add_cvd_risk_score_to_reporting_patient_prescriptions.rb
new file mode 100644
index 0000000000..d64f95d8b9
--- /dev/null
+++ b/db/migrate/20260316093605_add_cvd_risk_score_to_reporting_patient_prescriptions.rb
@@ -0,0 +1,403 @@
+class AddCvdRiskScoreToReportingPatientPrescriptions < ActiveRecord::Migration[6.1]
+  def up
+    execute <<~SQL
+      ALTER TABLE simple_reporting.reporting_patient_prescriptions
+      ADD COLUMN latest_cvd_risk_score_lower_range integer,
+      ADD COLUMN latest_cvd_risk_score_upper_range integer;
+
+      CREATE OR REPLACE VIEW public.reporting_patient_prescriptions AS SELECT * FROM simple_reporting.reporting_patient_prescriptions;
+    SQL
+
+    execute <<~SQL
+      CREATE INDEX idx_rpp_month_patient ON simple_reporting.reporting_patient_prescriptions (month_date, patient_id);
+      CREATE INDEX idx_rpp_latest_cvd_score_lower_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_lower_range);
+      CREATE INDEX idx_rpp_latest_cvd_score_upper_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_upper_range);
+    SQL
+
+    execute <<~SQL
+      CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_table_function(date) RETURNS SETOF simple_reporting.reporting_patient_prescriptions
+      LANGUAGE plpgsql
+      AS $_$
+      BEGIN
+        RETURN QUERY
+        SELECT
+          rps.patient_id,
+          rps.month_date,
+          rps.age,
+          rps.gender,
+          rps.hypertension,
+          rps.diabetes,
+          rps.last_bp_state,
+          rps.htn_care_state,
+          rps.months_since_bp,
+          rps.assigned_facility_id,
+          assigned_facility.facility_name AS assigned_facility_name,
+          rps.assigned_facility_size,
+          rps.assigned_facility_type,
+          rps.assigned_facility_slug,
+          rps.assigned_facility_region_id,
+          rps.assigned_block_slug,
+          rps.assigned_block_region_id,
+          assigned_facility.block_name AS assigned_block_name,
+          rps.assigned_district_slug,
+          rps.assigned_district_region_id,
+          assigned_facility.district_name AS assigned_district_name,
+          rps.assigned_state_slug,
+          rps.assigned_state_region_id,
+          assigned_facility.state_name AS assigned_state_name,
+          rps.assigned_organization_slug,
+          rps.assigned_organization_region_id,
+          assigned_facility.organization_name AS assigned_organization_name,
+          rps.registration_facility_id,
+          registration_facility.facility_name AS registration_facility_name,
+          rps.registration_facility_size,
+          rps.registration_facility_type,
+          rps.registration_facility_slug,
+          rps.registration_facility_region_id,
+          rps.registration_block_slug,
+          rps.registration_block_region_id,
+          registration_facility.block_name AS registration_block_name,
+          rps.registration_district_slug,
+          rps.registration_district_region_id,
+          registration_facility.district_name AS registration_district_name,
+          rps.registration_state_slug,
+          rps.registration_state_region_id,
+          registration_facility.state_name AS registration_state_name,
+          rps.registration_organization_slug,
+          rps.registration_organization_region_id,
+          registration_facility.organization_name AS registration_organization_name,
+
+          curr.hypertension_prescriptions,
+          curr.diabetes_prescriptions,
+          curr.other_prescriptions,
+
+          prev.hypertension_prescriptions AS previous_hypertension_prescriptions,
+          prev.diabetes_prescriptions     AS previous_diabetes_prescriptions,
+          prev.other_prescriptions        AS previous_other_prescriptions,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.hypertension_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.hypertension_prescriptions)
+          ) AS hypertension_drug_changed,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.diabetes_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.diabetes_prescriptions)
+          ) AS diabetes_drug_changed,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.other_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.other_prescriptions)
+          ) AS other_drug_changed,
+
+          (
+            EXISTS (
+              SELECT 1
+              FROM jsonb_array_elements(
+                COALESCE(curr.hypertension_prescriptions, '[]'::jsonb)
+                || COALESCE(curr.diabetes_prescriptions, '[]'::jsonb)
+                || COALESCE(curr.other_prescriptions, '[]'::jsonb)
+              ) elem
+              WHERE elem->>'drug_name' ILIKE '%statin%'
+            )
+          ) AS prescribed_statins,
+
+          cvd.latest_cvd_risk_score_lower_range,
+          cvd.latest_cvd_risk_score_upper_range
+
+        FROM simple_reporting.reporting_patient_states rps
+        LEFT JOIN reporting_facilities assigned_facility ON rps.assigned_facility_id = assigned_facility.facility_id
+        LEFT JOIN reporting_facilities registration_facility ON rps.registration_facility_id = registration_facility.facility_id
+
+        LEFT JOIN LATERAL (
+          SELECT
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.hypertension = true) AS hypertension_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.diabetes = true) AS diabetes_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (
+              WHERE
+                mp.name IS NULL OR (
+                  COALESCE(mp.hypertension,false) = false
+                  AND COALESCE(mp.diabetes,false) = false
+                )
+            ) AS other_prescriptions
+
+          FROM prescription_drugs pd
+          LEFT JOIN medicine_purposes mp ON mp.name = pd.name
+          WHERE pd.patient_id = rps.patient_id
+            AND pd.deleted_at IS NULL
+            AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_created_at)),'YYYY-MM') <= to_char(rps.month_date, 'YYYY-MM')
+            AND (pd.is_deleted = false
+              OR (
+                pd.is_deleted = true
+                AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_updated_at)), 'YYYY-MM') > to_char(rps.month_date, 'YYYY-MM')
+              )
+            )
+        ) curr ON TRUE
+
+        LEFT JOIN LATERAL (
+          SELECT
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.hypertension = true) AS hypertension_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.diabetes = true) AS diabetes_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (
+              WHERE
+                mp.name IS NULL OR (
+                  COALESCE(mp.hypertension,false) = false
+                  AND COALESCE(mp.diabetes,false) = false
+                )
+            ) AS other_prescriptions
+          
+          FROM prescription_drugs pd
+          LEFT JOIN medicine_purposes mp ON mp.name = pd.name
+          WHERE pd.patient_id = rps.patient_id
+            AND pd.deleted_at IS NULL
+            AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_created_at)), 'YYYY-MM') <= to_char(rps.month_date - INTERVAL '1 month', 'YYYY-MM')
+            AND ( pd.is_deleted = false
+              OR (
+                pd.is_deleted = true
+                AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_updated_at)), 'YYYY-MM') > to_char(rps.month_date - INTERVAL '1 month', 'YYYY-MM')
+              )
+            )
+        ) prev ON TRUE
+
+        LEFT JOIN LATERAL (
+          SELECT
+            split_part(cr.risk_score,'-',1)::int AS latest_cvd_risk_score_lower_range,
+
+            COALESCE(
+              NULLIF(split_part(cr.risk_score,'-',2),''),
+              split_part(cr.risk_score,'-',1)
+            )::int AS latest_cvd_risk_score_upper_range
+
+          FROM cvd_risks cr
+          WHERE cr.patient_id = rps.patient_id
+            AND cr.deleted_at IS NULL
+            AND date_trunc('month',
+                  timezone(current_setting('TIMEZONE'),
+                  timezone('UTC', cr.device_updated_at))
+                ) < (rps.month_date + interval '1 month')
+
+          ORDER BY cr.device_updated_at DESC
+          LIMIT 1
+        ) cvd ON TRUE
+
+        WHERE rps.month_date = $1
+        AND rps.htn_care_state <> 'dead';
+      END;
+      $_$;
+    SQL
+  end
+
+  def down
+    execute <<~SQL
+      DROP VIEW IF EXISTS public.reporting_patient_prescriptions;
+      ALTER TABLE simple_reporting.reporting_patient_prescriptions
+      DROP COLUMN latest_cvd_risk_score_lower_range,
+      DROP COLUMN latest_cvd_risk_score_upper_range;
+
+      CREATE OR REPLACE VIEW public.reporting_patient_prescriptions AS SELECT * FROM simple_reporting.reporting_patient_prescriptions;
+    SQL
+
+    execute <<~SQL
+      DROP INDEX IF EXISTS simple_reporting.idx_rpp_month_patient;
+      DROP INDEX IF EXISTS simple_reporting.idx_rpp_latest_cvd_score_lower_range;
+      DROP INDEX IF EXISTS simple_reporting.idx_rpp_latest_cvd_score_upper_range;
+    SQL
+
+    execute <<~SQL
+      CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_table_function(date) RETURNS SETOF simple_reporting.reporting_patient_prescriptions
+      LANGUAGE plpgsql
+      AS $_$
+      BEGIN
+        RETURN QUERY
+        SELECT
+          rps.patient_id,
+          rps.month_date,
+          rps.age,
+          rps.gender,
+          rps.hypertension,
+          rps.diabetes,
+          rps.last_bp_state,
+          rps.htn_care_state,
+          rps.months_since_bp,
+          rps.assigned_facility_id,
+          assigned_facility.facility_name AS assigned_facility_name,
+          rps.assigned_facility_size,
+          rps.assigned_facility_type,
+          rps.assigned_facility_slug,
+          rps.assigned_facility_region_id,
+          rps.assigned_block_slug,
+          rps.assigned_block_region_id,
+          assigned_facility.block_name AS assigned_block_name,
+          rps.assigned_district_slug,
+          rps.assigned_district_region_id,
+          assigned_facility.district_name AS assigned_district_name,
+          rps.assigned_state_slug,
+          rps.assigned_state_region_id,
+          assigned_facility.state_name AS assigned_state_name,
+          rps.assigned_organization_slug,
+          rps.assigned_organization_region_id,
+          assigned_facility.organization_name AS assigned_organization_name,
+          rps.registration_facility_id,
+          registration_facility.facility_name AS registration_facility_name,
+          rps.registration_facility_size,
+          rps.registration_facility_type,
+          rps.registration_facility_slug,
+          rps.registration_facility_region_id,
+          rps.registration_block_slug,
+          rps.registration_block_region_id,
+          registration_facility.block_name AS registration_block_name,
+          rps.registration_district_slug,
+          rps.registration_district_region_id,
+          registration_facility.district_name AS registration_district_name,
+          rps.registration_state_slug,
+          rps.registration_state_region_id,
+          registration_facility.state_name AS registration_state_name,
+          rps.registration_organization_slug,
+          rps.registration_organization_region_id,
+          registration_facility.organization_name AS registration_organization_name,
+
+          curr.hypertension_prescriptions,
+          curr.diabetes_prescriptions,
+          curr.other_prescriptions,
+
+          prev.hypertension_prescriptions AS previous_hypertension_prescriptions,
+          prev.diabetes_prescriptions     AS previous_diabetes_prescriptions,
+          prev.other_prescriptions        AS previous_other_prescriptions,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.hypertension_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.hypertension_prescriptions)
+          ) AS hypertension_drug_changed,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.diabetes_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.diabetes_prescriptions)
+          ) AS diabetes_drug_changed,
+
+          (
+            simple_reporting.normalize_jsonb_array(curr.other_prescriptions)
+            IS DISTINCT FROM
+            simple_reporting.normalize_jsonb_array(prev.other_prescriptions)
+          ) AS other_drug_changed,
+
+          (
+            EXISTS (
+              SELECT 1
+              FROM jsonb_array_elements(
+                COALESCE(curr.hypertension_prescriptions, '[]'::jsonb)
+                || COALESCE(curr.diabetes_prescriptions, '[]'::jsonb)
+                || COALESCE(curr.other_prescriptions, '[]'::jsonb)
+              ) elem
+              WHERE elem->>'drug_name' ILIKE '%statin%'
+            )
+          ) AS prescribed_statins
+
+        FROM simple_reporting.reporting_patient_states rps
+        LEFT JOIN reporting_facilities assigned_facility ON rps.assigned_facility_id = assigned_facility.facility_id
+        LEFT JOIN reporting_facilities registration_facility ON rps.registration_facility_id = registration_facility.facility_id
+
+        LEFT JOIN LATERAL (
+          SELECT
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.hypertension = true) AS hypertension_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.diabetes = true) AS diabetes_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (
+              WHERE
+                mp.name IS NULL OR (
+                  COALESCE(mp.hypertension,false) = false
+                  AND COALESCE(mp.diabetes,false) = false
+                )
+            ) AS other_prescriptions
+
+          FROM prescription_drugs pd
+          LEFT JOIN medicine_purposes mp ON mp.name = pd.name
+          WHERE pd.patient_id = rps.patient_id
+            AND pd.deleted_at IS NULL
+            AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_created_at)),'YYYY-MM') <= to_char(rps.month_date, 'YYYY-MM')
+            AND (pd.is_deleted = false
+              OR (
+                pd.is_deleted = true
+                AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_updated_at)), 'YYYY-MM') > to_char(rps.month_date, 'YYYY-MM')
+              )
+            )
+        ) curr ON TRUE
+
+        LEFT JOIN LATERAL (
+          SELECT
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.hypertension = true) AS hypertension_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (WHERE mp.diabetes = true) AS diabetes_prescriptions,
+
+            jsonb_agg(jsonb_build_object(
+              'drug_name', pd.name,
+              'dosage', pd.dosage
+            )) FILTER (
+              WHERE
+                mp.name IS NULL OR (
+                  COALESCE(mp.hypertension,false) = false
+                  AND COALESCE(mp.diabetes,false) = false
+                )
+            ) AS other_prescriptions
+          
+          FROM prescription_drugs pd
+          LEFT JOIN medicine_purposes mp ON mp.name = pd.name
+          WHERE pd.patient_id = rps.patient_id
+            AND pd.deleted_at IS NULL
+            AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_created_at)), 'YYYY-MM') <= to_char(rps.month_date - INTERVAL '1 month', 'YYYY-MM')
+            AND ( pd.is_deleted = false
+              OR (
+                pd.is_deleted = true
+                AND to_char(timezone(current_setting('TIMEZONE'), timezone('UTC', pd.device_updated_at)), 'YYYY-MM') > to_char(rps.month_date - INTERVAL '1 month', 'YYYY-MM')
+              )
+            )
+        ) prev ON TRUE
+        WHERE rps.month_date = $1
+        AND rps.htn_care_state <> 'dead';
+      END;
+      $_$;
+    SQL
+  end
+end
diff --git a/db/structure.sql b/db/structure.sql
index 5ff0b863cd..282b50711c 100644
--- a/db/structure.sql
+++ b/db/structure.sql
@@ -748,7 +748,9 @@ CREATE TABLE IF NOT EXISTS simple_reporting.reporting_patient_prescriptions (
     hypertension_drug_changed boolean,
     diabetes_drug_changed boolean,
     other_drug_changed boolean,
-    prescribed_statins boolean
+    prescribed_statins boolean,
+    latest_cvd_risk_score_lower_range integer,
+    latest_cvd_risk_score_upper_range integer
     )
     PARTITION BY LIST (month_date);
 
@@ -863,7 +865,10 @@ CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_tabl
             ) elem
             WHERE elem->>'drug_name' ILIKE '%statin%'
         )
-        ) AS prescribed_statins
+        ) AS prescribed_statins,
+
+        cvd.latest_cvd_risk_score_lower_range,
+        cvd.latest_cvd_risk_score_upper_range
 
     FROM simple_reporting.reporting_patient_states rps
     LEFT JOIN reporting_facilities assigned_facility ON rps.assigned_facility_id = assigned_facility.facility_id
@@ -940,6 +945,27 @@ CREATE OR REPLACE FUNCTION simple_reporting.reporting_patient_prescriptions_tabl
             )
         )
     ) prev ON TRUE
+
+    LEFT JOIN LATERAL (
+        SELECT
+        split_part(cr.risk_score,'-',1)::int AS latest_cvd_risk_score_lower_range,
+
+        COALESCE(
+            NULLIF(split_part(cr.risk_score,'-',2),''),
+            split_part(cr.risk_score,'-',1)
+        )::int AS latest_cvd_risk_score_upper_range
+
+        FROM cvd_risks cr
+        WHERE cr.patient_id = rps.patient_id
+        AND cr.deleted_at IS NULL
+        AND date_trunc('month',
+                timezone(current_setting('TIMEZONE'),
+                timezone('UTC', cr.device_updated_at))
+            ) < (rps.month_date + interval '1 month')
+
+        ORDER BY cr.device_updated_at DESC
+        LIMIT 1
+    ) cvd ON TRUE
     WHERE rps.month_date = $1
     AND rps.htn_care_state <> 'dead';
     END;
@@ -9083,6 +9109,24 @@ CREATE INDEX patient_prescriptions_assigned_organization_region_id ON ONLY simpl
 
 CREATE INDEX index_patient_prescriptions_patient_id ON ONLY simple_reporting.reporting_patient_prescriptions USING btree (patient_id);
 
+--
+-- Name: idx_rpp_month_patient; Type: INDEX; Schema: simple_reporting; Owner: -
+--
+
+CREATE INDEX idx_rpp_month_patient ON simple_reporting.reporting_patient_prescriptions (month_date, patient_id);
+
+--
+-- Name: idx_rpp_latest_cvd_score_lower_range; Type: INDEX; Schema: simple_reporting; Owner: -
+--
+
+CREATE INDEX idx_rpp_latest_cvd_score_lower_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_lower_range);
+
+--
+-- Name: idx_rpp_latest_cvd_score_upper_range; Type: INDEX; Schema: simple_reporting; Owner: -
+--
+
+CREATE INDEX idx_rpp_latest_cvd_score_upper_range ON simple_reporting.reporting_patient_prescriptions (latest_cvd_risk_score_upper_range);
+
 --
 -- Name: index_fs_block; Type: INDEX; Schema: simple_reporting; Owner: -
 --
@@ -9678,5 +9722,6 @@ INSERT INTO "schema_migrations" (version) VALUES
 ('20260205110957'),
 ('20260224063659'),
 ('20260120115014'),
-('20260127150000');
+('20260127150000'),
+('20260316093605');