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
9,272
Total Claims
$3.9M
Drug Cost
1,023
Beneficiaries
$3,855
Cost/Patient
Risk Score Breakdown 9/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+265%
Opioid rate vs peers
14.8% vs 4.1% avg
-36%
Cost per patient vs peers
$3,855 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 265% 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
14.8%
Opioid Rate
1,373
Opioid Claims
$26K
Opioid Cost
3.2%
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 7,953 claims · $216K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Adalimumab | 97 | $843K |
| Belimumab | 87 | $434K |
| Etanercept | 50 | $368K |
| Adalimumab | 39 | $311K |
| Upadacitinib | 41 | $266K |
| Etanercept | 36 | $263K |
| Etanercept | 32 | $244K |
| Apremilast | 44 | $210K |
| Secukinumab | 14 | $124K |
| Tofacitinib Citrate | 21 | $113K |
| Ixekizumab | 12 | $86K |
| Adalimumab | 11 | $75K |
| Hydroxychloroquine Sulfate | 985 | $52K |
| Methotrexate Sodium | 1,065 | $34K |
| Tocilizumab | 11 | $27K |
Prescribing Profile
Patient Profile
69
Avg Age
75%
Female
1.62
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