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
10,300
Total Claims
$1.8M
Drug Cost
964
Beneficiaries
$1,896
Cost/Patient
Risk Score Breakdown 9/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+238%
Opioid rate vs peers
13.7% vs 4.1% avg
-69%
Cost per patient vs peers
$1,896 vs $6,039 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
Opioid rate is 238% above Rheumatology peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
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
13.7%
Opioid Rate
1,414
Opioid Claims
$17K
Opioid Cost
0.8%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 9,907 claims · $386K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Adalimumab | 22 | $216K |
| Adalimumab | 25 | $180K |
| Etanercept | 15 | $151K |
| Abatacept | 12 | $106K |
| Hydroxychloroquine Sulfate | 977 | $87K |
| Methotrexate Sodium | 914 | $51K |
| Leflunomide | 474 | $50K |
| Pregabalin | 347 | $25K |
| Celecoxib | 404 | $23K |
| Prednisone | 1,111 | $16K |
| Pilocarpine Hcl | 105 | $12K |
| Milnacipran Hcl | 22 | $12K |
| Colchicine | 89 | $11K |
| Duloxetine Hcl | 228 | $10K |
| Gabapentin | 301 | $8,305 |
Prescribing Profile
Patient Profile
73
Avg Age
77%
Female
1.66
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