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
1,490
Total Claims
$612K
Drug Cost
232
Beneficiaries
$2,636
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+725%
Opioid rate vs peers
33.5% vs 4.1% avg
-56%
Cost per patient vs peers
$2,636 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 725% 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
33.5%
Opioid Rate
499
Opioid Claims
$12K
Opioid Cost
8.0%
Long-Acting Rate
This provider's opioid prescribing rate of 33.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 1,338 claims · $41K
Patient Profile
75
Avg Age
53%
Female
1.58
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About