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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 →Risk Flags
Elevated cost per beneficiary
Risk indicators are statistical patterns, not allegations. Learn more
885
Total Claims
$1.2M
Drug Cost
103
Beneficiaries
$11K
Cost/Patient
Risk Score Breakdown 3/100
Low (0)Moderate (15)Elevated (30)High (50+)
Cost per patient outlier+3
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+88%
Cost per patient vs peers
$11K vs $6,039 avg
Brand vs Generic
100% generic
Brand: 0 claims · $0
Generic: 658 claims · $35K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Etanercept | 45 | $320K |
| Adalimumab | 37 | $265K |
| Adalimumab | 18 | $125K |
| Tofacitinib Citrate | 18 | $100K |
| Abatacept | 11 | $66K |
| Abatacept | 11 | $58K |
| Hydroxychloroquine Sulfate | 167 | $11K |
| Methotrexate Sodium | 172 | $7,174 |
| Cyclosporine | 14 | $6,671 |
| Leflunomide | 56 | $3,082 |
| Pilocarpine Hcl | 26 | $1,754 |
| Gabapentin | 42 | $1,488 |
| Prednisone | 73 | $859 |
| Celecoxib | 19 | $400 |
| Naproxen | 27 | $385 |
Prescribing Profile
Patient Profile
69
Avg Age
76%
Female
1.59
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