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
4,269
Total Claims
$1.3M
Drug Cost
661
Beneficiaries
$2,026
Cost/Patient
Risk Score Breakdown 40/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+712%
Opioid rate vs peers
33.0% vs 4.1% avg
-66%
Cost per patient vs peers
$2,026 vs $6,039 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 712% 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
33.0%
Opioid Rate
1,407
Opioid Claims
$113K
Opioid Cost
21.2%
Long-Acting Rate
This provider's opioid prescribing rate of 33.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 3,740 claims · $137K
Patient Profile
66
Avg Age
82%
Female
1.61
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