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
10,909
Total Claims
$1.3M
Drug Cost
602
Beneficiaries
$2,210
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 13,124 General Surgery providers
-71%
Opioid rate vs peers
8.7% vs 30.2% avg
+774%
Cost per patient vs peers
$2,210 vs $253 avg
+144%
Brand preference vs peers
12.2% vs 5.0% 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.
🔎 Data Overview
Cost per patient is 774% 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
8.7%
Opioid Rate
948
Opioid Claims
$8,757
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 1,323 claims · $878K
Generic: 9,524 claims · $450K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Semaglutide | 309 | $316K |
| Diclofenac Potassium | 102 | $198K |
| Dulaglutide | 128 | $146K |
| Omeprazole/Sodium Bicarbonate | 54 | $98K |
| Diclofenac Sodium | 1,049 | $49K |
| Sitagliptin Phosphate | 72 | $45K |
| Apixaban | 74 | $44K |
| Linaclotide | 64 | $42K |
| Semaglutide | 34 | $39K |
| Tirzepatide | 33 | $36K |
| Dapagliflozin Propanediol | 36 | $24K |
| Mirabegron | 21 | $13K |
| Sitagliptin Phos/Metformin Hcl | 19 | $11K |
| Suvorexant | 24 | $11K |
| Insulin Glargine,hum.Rec.Anlog | 22 | $11K |
Prescribing Profile
Patient Profile
73
Avg Age
59%
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