⚠️

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 →

Sunil PatelD.O.

Nephrology · Apple Valley, CA 92307

NPI: 1134274012

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26

🟡 Moderate

Risk Flags

High cost outlier (population + peer)High brand-name preferenceElevated antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriber

Risk indicators are statistical patterns, not allegations. Learn more

9,872

Total Claims

$6.1M

Drug Cost

616

Beneficiaries

$9,884

Cost/Patient

Risk Score Breakdown 26/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid + benzodiazepine combo+8
Cost per patient outlier+6
Elderly antipsychotic prescribing+5
Brand-name preference+4

Score components are additive. Read full methodology

Peer Comparison vs. 8,961 Nephrology providers

+670%

Cost per patient vs peers

$9,884 vs $1,283 avg

+246%

Brand preference vs peers

31.0% vs 9.0% avg

⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.

⚠️ 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 670% 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

0.7%

Opioid Rate

72

Opioid Claims

$2,037

Opioid Cost

Long-Acting Rate

Brand vs Generic

69% generic

Brand: 3,008 claims · $5.8M

Generic: 6,688 claims · $246K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Pegloticase64$3.6M
Ferric Citrate107$274K
Finerenone283$211K
Dapagliflozin Propanediol279$185K
Calcifediol133$170K
Dulaglutide116$141K
Sucroferric Oxyhydroxide32$107K
Semaglutide71$73K
Empagliflozin98$71K
Apixaban111$66K
Patiromer Calcium Sorbitex60$65K
Tirzepatide54$61K
Sitagliptin Phosphate71$49K
Sodium Zirconium Cyclosilicate64$45K
Alirocumab73$43K

Prescribing Profile

144

Unique Drugs

$451K

IRA Negotiated Drugs

$287K

GLP-1 Drugs

26.0

Anomaly Score

Patient Profile

71

Avg Age

54%

Female

3.24

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