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
41,808
Total Claims
$6.2M
Drug Cost
1,324
Beneficiaries
$4,697
Cost/Patient
Risk Score Breakdown 38/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
+504%
Opioid rate vs peers
13.5% vs 2.2% avg
+233%
Cost per patient vs peers
$4,697 vs $1,411 avg
+14%
Brand preference vs peers
12.1% 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.
🔎 Data Overview
Opioid prescribing rate is 504% above the average for Internal Medicine providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
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
13.5%
Opioid Rate
5,648
Opioid Claims
$270K
Opioid Cost
12.2%
Long-Acting Rate
Brand vs Generic
Brand: 5,044 claims · $5.0M
Generic: 36,473 claims · $1.2M
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Bictegrav/Emtricit/Tenofov Ala | 198 | $803K |
| Darunavir/Cob/Emtri/Tenof Alaf | 162 | $799K |
| Emtricitab/Rilpiviri/Tenof Ala | 100 | $395K |
| Semaglutide | 316 | $390K |
| Tirzepatide | 158 | $192K |
| Raltegravir Potassium | 70 | $138K |
| Emtricita/Rilpivirine/Tenof Df | 35 | $132K |
| Elviteg/Cob/Emtri/Tenof Alafen | 30 | $124K |
| Linaclotide | 156 | $117K |
| Emtricitabine/Tenofov Alafenam | 50 | $116K |
| Hydrocodone/Acetaminophen | 2,897 | $115K |
| Abacavir/Dolutegravir/Lamivudi | 27 | $103K |
| Mirabegron | 154 | $94K |
| Insulin Glargine,hum.Rec.Anlog | 100 | $73K |
| Budesonide/Formoterol Fumarate | 144 | $69K |
Prescribing Profile
Patient Profile
66
Avg Age
74%
Female
1.55
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