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
24,396
Total Claims
$4.7M
Drug Cost
531
Beneficiaries
$8,769
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 110,156 Internal Medicine providers
-87%
Opioid rate vs peers
0.3% vs 2.2% avg
+521%
Cost per patient vs peers
$8,769 vs $1,411 avg
+150%
Brand preference vs peers
26.6% 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 521% 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
0.3%
Opioid Rate
70
Opioid Claims
$1,210
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 6,378 claims · $4.0M
Generic: 17,608 claims · $624K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Lipase/Protease/Amylase | 304 | $384K |
| Sitagliptin Phosphate | 368 | $268K |
| Linaclotide | 435 | $256K |
| Sitagliptin Phos/Metformin Hcl | 308 | $206K |
| Semaglutide | 154 | $165K |
| Apixaban | 221 | $159K |
| Icosapent Ethyl | 410 | $159K |
| Lipase/Protease/Amylase | 96 | $138K |
| Metformin Hcl | 40 | $138K |
| Metformin Hcl | 63 | $121K |
| Prednisone | 26 | $87K |
| Denosumab | 48 | $82K |
| Empagliflozin | 96 | $77K |
| Dexlansoprazole | 290 | $74K |
| Dulaglutide | 68 | $71K |
Prescribing Profile
Patient Profile
76
Avg Age
67%
Female
1.62
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