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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 →

Cesar RomeroMD

Internal Medicine · Hamilton, AL 35570

NPI: 1003870494

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24

🟡 Moderate

🤖 ML Fraud Detection Score: 98%

Machine learning model identifies prescribing patterns consistent with confirmed fraud cases. This is a statistical indicator, not an accusation.

Learn more →

Risk Flags

High antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberHigh fills per patient

Risk indicators are statistical patterns, not allegations. Learn more

11,783

Total Claims

$1.2M

Drug Cost

460

Beneficiaries

$2,697

Cost/Patient

Risk Score Breakdown 24/100

Low (0)Moderate (15)Elevated (30)High (50+)
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8
High fills per patient+3

Score components are additive. Read full methodology

Peer Comparison vs. 110,156 Internal Medicine providers

+71%

Opioid rate vs peers

3.8% vs 2.2% avg

+91%

Cost per patient vs peers

$2,697 vs $1,411 avg

+38%

Brand preference vs peers

14.7% vs 10.6% avg

⚠️ 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.

Opioid Prescribing

3.8%

Opioid Rate

451

Opioid Claims

$8,529

Opioid Cost

Long-Acting Rate

Brand vs Generic

85% generic

Brand: 1,721 claims · $1.0M

Generic: 10,003 claims · $197K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Semaglutide225$242K
Empagliflozin212$174K
Apixaban138$106K
Dulaglutide94$94K
Dapagliflozin Propanediol57$54K
Sitagliptin Phosphate90$54K
Sacubitril/Valsartan61$49K
Tirzepatide22$24K
Budesonide/Formoterol Fumarate57$24K
Rivaroxaban26$22K
Mirabegron25$15K
Insulin Aspart25$15K
Rosuvastatin Calcium668$15K
Pregabalin89$13K
Esomeprazole Magnesium145$12K

Prescribing Profile

128

Unique Drugs

$474K

IRA Negotiated Drugs

$361K

GLP-1 Drugs

24.0

Anomaly Score

Patient Profile

75

Avg Age

53%

Female

1.31

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.Methodology · About