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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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Sergio Martinez

Pulmonary Disease · Jackson Heights, NY 11372

NPI: 1336171040

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12

🟢 Low

Risk Flags

High antipsychotic prescribing (65+)

Risk indicators are statistical patterns, not allegations. Learn more

18,218

Total Claims

$4.8M

Drug Cost

1,555

Beneficiaries

$3,099

Cost/Patient

Risk Score Breakdown 12/100

Low (0)Moderate (15)Elevated (30)High (50+)
Elderly antipsychotic prescribing+10

Score components are additive. Read full methodology

Peer Comparison vs. 9,082 Pulmonary Disease providers

-40%

Cost per patient vs peers

$3,099 vs $5,138 avg

-51%

Brand preference vs peers

29.9% vs 61.4% avg

Brand vs Generic

70% generic

Brand: 5,362 claims · $3.9M

Generic: 12,590 claims · $957K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Nintedanib Esylate26$438K
Fluticasone/Umeclidin/Vilanter493$390K
Budesonide/Formoterol Fumarate421$207K
Budesonide46$198K
Chlorpromazine Hcl171$192K
Fluticasone/Vilanterol401$190K
Cyclosporine115$179K
Semaglutide89$153K
Icosapent Ethyl179$129K
Sitagliptin Phosphate112$122K
Umeclidinium Bromide275$120K
Linaclotide120$119K
Fluticasone Propion/Salmeterol231$119K
Empagliflozin94$109K
Dulaglutide57$95K

Prescribing Profile

166

Unique Drugs

$475K

IRA Negotiated Drugs

$327K

GLP-1 Drugs

12.0

Anomaly Score

Patient Profile

73

Avg Age

57%

Female

1.40

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