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
550
Total Claims
$293K
Drug Cost
143
Beneficiaries
$2,049
Cost/Patient
Risk Score Breakdown 35/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+1293%
Opioid rate vs peers
56.5% vs 4.1% avg
-66%
Cost per patient vs peers
$2,049 vs $6,039 avg
-7%
Brand preference vs peers
7.1% vs 7.6% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid prescribing rate is 1,293% above the average for Rheumatology providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
56.5%
Opioid Rate
311
Opioid Claims
$2,470
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 56.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 39 claims · $278K
Generic: 511 claims · $14K
Patient Profile
73
Avg Age
83%
Female
1.77
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