⚠️

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 →

Nadarajah NirmalanMD

Internal Medicine · St Petersburg, FL 33703

NPI: 1043311699

Share:

43

🟠 Elevated

Risk Flags

High opioid rate vs specialty peersElevated long-acting opioid rateHigh antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriberExtreme fills per patient

Risk indicators are statistical patterns, not allegations. Learn more

16,307

Total Claims

$2.1M

Drug Cost

458

Beneficiaries

$4,510

Cost/Patient

Risk Score Breakdown 43/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+10
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8
High fills per patient+5
Long-acting opioid rate+4

Score components are additive. Read full methodology

Peer Comparison vs. 110,156 Internal Medicine providers

+448%

Opioid rate vs peers

12.3% vs 2.2% avg

+220%

Cost per patient vs peers

$4,510 vs $1,411 avg

+42%

Brand preference vs peers

15.1% 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 rate is 448% above Internal Medicine peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.

⚠️

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

12.3%

Opioid Rate

2,002

Opioid Claims

$137K

Opioid Cost

15.0%

Long-Acting Rate

Brand vs Generic

85% generic

Brand: 2,443 claims · $1.6M

Generic: 13,699 claims · $461K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Semaglutide179$215K
Dulaglutide114$113K
Apixaban172$108K
Etanercept14$107K
Octreotide Acetate,mi-Spheres14$100K
Linaclotide120$83K
Fluticasone/Umeclidin/Vilanter82$59K
Dapagliflozin Propanediol57$50K
Mirabegron98$49K
Cariprazine Hcl30$44K
Oxycodone Hcl52$42K
Rifaximin11$38K
Budesonide/Formoterol Fumarate68$37K
Sitagliptin Phosphate34$36K
Insulin Detemir46$36K

Prescribing Profile

216

Unique Drugs

$316K

IRA Negotiated Drugs

$372K

GLP-1 Drugs

43.0

Anomaly Score

Patient Profile

71

Avg Age

56%

Female

1.87

Avg Risk Score

Explore More

Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About