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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
11,387
Total Claims
$6.3M
Drug Cost
976
Beneficiaries
$6,411
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
+6%
Cost per patient vs peers
$6,411 vs $6,039 avg
+45%
Brand preference vs peers
11.0% vs 7.6% avg
Brand vs Generic
89% generic
Brand: 1,247 claims · $6.1M
Generic: 10,123 claims · $173K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Etanercept | 345 | $2.1M |
| Adalimumab | 250 | $1.8M |
| Denosumab | 178 | $294K |
| Abatacept | 46 | $263K |
| Upadacitinib | 33 | $217K |
| Golimumab | 32 | $203K |
| Etanercept | 24 | $170K |
| Secukinumab | 21 | $157K |
| Tofacitinib Citrate | 19 | $115K |
| Etanercept | 13 | $98K |
| Secukinumab | 13 | $96K |
| Certolizumab Pegol | 16 | $92K |
| Infliximab | 14 | $72K |
| Apremilast | 14 | $65K |
| Abatacept/Maltose | 12 | $47K |
Prescribing Profile
Patient Profile
74
Avg Age
84%
Female
1.90
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