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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 →

Cesar Goya

Nurse Practitioner · Miami, FL 33174

NPI: 1326552431

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21

🟡 Moderate

Risk Flags

High antipsychotic prescribing (65+)Opioid + benzodiazepine co-prescriber

Risk indicators are statistical patterns, not allegations. Learn more

19,284

Total Claims

$1.8M

Drug Cost

1,073

Beneficiaries

$1,638

Cost/Patient

Risk Score Breakdown 21/100

Low (0)Moderate (15)Elevated (30)High (50+)
Elderly antipsychotic prescribing+10
Opioid + benzodiazepine combo+8

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

-98%

Opioid rate vs peers

0.1% vs 3.8% avg

+39%

Cost per patient vs peers

$1,638 vs $1,174 avg

+27%

Brand preference vs peers

11.3% vs 8.9% 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

⚠️

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

0.1%

Opioid Rate

15

Opioid Claims

$65

Opioid Cost

Long-Acting Rate

Brand vs Generic

89% generic

Brand: 2,110 claims · $1.4M

Generic: 16,596 claims · $355K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Sitagliptin Phosphate149$185K
Apixaban168$166K
Insulin Glargine,hum.Rec.Anlog130$68K
Sacubitril/Valsartan41$62K
Rivaroxaban48$59K
Linagliptin35$56K
Budesonide/Formoterol Fumarate116$46K
Icosapent Ethyl91$45K
Linaclotide47$43K
Empagliflozin38$39K
Sitagliptin Phos/Metformin Hcl34$39K
Semaglutide37$37K
Dapagliflozin Propanediol29$33K
Fluticasone Propion/Salmeterol59$25K
Icosapent Ethyl57$24K

Prescribing Profile

179

Unique Drugs

$544K

IRA Negotiated Drugs

$59K

GLP-1 Drugs

21.0

Anomaly Score

Patient Profile

74

Avg Age

61%

Female

1.90

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 of wrongdoing.Methodology · About · Dispute this data