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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.

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Sandeep PadalaMD

Nephrology · Augusta, GA 30912

NPI: 1134416563

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31

🟠 Elevated

Risk Flags

Extreme opioid rate vs specialty peersHigh cost outlier (population + peer)

Risk indicators are statistical patterns, not allegations. Learn more

175

Total Claims

$342K

Drug Cost

68

Beneficiaries

$5,035

Cost/Patient

Risk Score Breakdown 31/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+25
Cost per patient outlier+6

Score components are additive. Read full methodology

Peer Comparison vs. 8,961 Nephrology providers

+292%

Cost per patient vs peers

$5,035 vs $1,283 avg

+79%

Brand preference vs peers

16.0% vs 9.0% avg

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

Opioid Prescribing

21.1%

Opioid Rate

37

Opioid Claims

$288

Opioid Cost

Long-Acting Rate

This provider's opioid prescribing rate of 21.1% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

84% generic

Brand: 28 claims · $339K

Generic: 147 claims · $2,957

Patient Profile

65

Avg Age

52%

Female

3.55

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