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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
Elevated cost per beneficiary
Risk indicators are statistical patterns, not allegations. Learn more
15,287
Total Claims
$6.3M
Drug Cost
1,100
Beneficiaries
$5,683
Cost/Patient
Risk Score Breakdown 3/100
Low (0)Moderate (15)Elevated (30)High (50+)
Cost per patient outlier+3
Score components are additive. Read full methodology
Peer Comparison vs. 9,082 Pulmonary Disease providers
+11%
Cost per patient vs peers
$5,683 vs $5,138 avg
Brand vs Generic
100% generic
Brand: 0 claims · $0
Generic: 9,352 claims · $505K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Riociguat | 119 | $1.6M |
| Macitentan | 83 | $1.0M |
| Fluticasone/Vilanterol | 1,829 | $746K |
| Nintedanib Esylate | 48 | $598K |
| Fluticasone/Umeclidin/Vilanter | 484 | $317K |
| Ambrisentan | 25 | $303K |
| Pirfenidone | 32 | $212K |
| Treprostinil Diolamine | 13 | $167K |
| Tiotropium Br/Olodaterol Hcl | 349 | $167K |
| Bosentan | 13 | $157K |
| Tiotropium Bromide | 236 | $124K |
| Ambrisentan | 21 | $105K |
| Albuterol Sulfate | 2,138 | $100K |
| Umeclidinium Brm/Vilanterol Tr | 208 | $98K |
| Budesonide/Formoterol Fumarate | 143 | $56K |
Prescribing Profile
38
Unique Drugs
3.0
Anomaly Score
Patient Profile
71
Avg Age
62%
Female
2.16
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