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
34,592
Total Claims
$9.0M
Drug Cost
737
Beneficiaries
$12K
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 18,720 Cardiology providers
+704%
Cost per patient vs peers
$12K vs $1,524 avg
+179%
Brand preference vs peers
38.1% vs 13.7% 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
Cost per patient is 704% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
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.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
0.5%
Opioid Rate
160
Opioid Claims
$904
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 13,144 claims · $7.8M
Generic: 21,328 claims · $1.2M
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Sacubitril/Valsartan | 1,199 | $916K |
| Lipase/Protease/Amylase | 585 | $808K |
| Rivaroxaban | 1,113 | $700K |
| Dapagliflozin Propanediol | 960 | $608K |
| Icosapent Ethyl | 1,200 | $467K |
| Semaglutide | 304 | $315K |
| Alirocumab | 564 | $311K |
| Linaclotide | 415 | $244K |
| Pitavastatin Calcium | 626 | $230K |
| Diclofenac Sodium | 300 | $204K |
| Metformin Hcl | 65 | $202K |
| Tirzepatide | 171 | $192K |
| Apixaban | 310 | $192K |
| Diclofenac Sodium | 69 | $181K |
| Dronedarone Hcl | 213 | $180K |
Prescribing Profile
Patient Profile
80
Avg Age
65%
Female
1.98
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