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
24,992
Total Claims
$5.4M
Drug Cost
539
Beneficiaries
$9,982
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
-93%
Opioid rate vs peers
0.2% vs 2.2% avg
+607%
Cost per patient vs peers
$9,982 vs $1,411 avg
+131%
Brand preference vs peers
24.5% 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
Cost per patient is 607% 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
0.2%
Opioid Rate
39
Opioid Claims
$388
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 5,915 claims · $4.6M
Generic: 18,216 claims · $799K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Icosapent Ethyl | 731 | $566K |
| Linaclotide | 444 | $467K |
| Empagliflozin | 246 | $334K |
| Dapagliflozin Propanediol | 248 | $290K |
| Sitagliptin Phosphate | 287 | $273K |
| Diclofenac Epolamine | 332 | $222K |
| Sitagliptin Phos/Metformin Hcl | 190 | $215K |
| Cyclosporine | 223 | $198K |
| Lipase/Protease/Amylase | 93 | $159K |
| Denosumab | 80 | $138K |
| Tenofovir Alafenamide | 79 | $126K |
| Apixaban | 127 | $105K |
| Semaglutide | 93 | $99K |
| Omeprazole/Sodium Bicarbonate | 70 | $86K |
| Budesonide/Formoterol Fumarate | 188 | $78K |
Prescribing Profile
Patient Profile
74
Avg Age
51%
Female
1.12
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