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
21,361
Total Claims
$10.2M
Drug Cost
1,764
Beneficiaries
$5,764
Cost/Patient
Risk Score Breakdown 3/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+250%
Opioid rate vs peers
14.2% vs 4.1% avg
-5%
Cost per patient vs peers
$5,764 vs $6,039 avg
🔎 Data Overview
Opioid rate is 250% above Rheumatology peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
14.2%
Opioid Rate
3,033
Opioid Claims
$37K
Opioid Cost
—
Long-Acting Rate
Brand vs Generic
Brand: 0 claims · $0
Generic: 19,119 claims · $384K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Adalimumab | 392 | $2.9M |
| Etanercept | 218 | $1.6M |
| Etanercept | 115 | $846K |
| Tofacitinib Citrate | 127 | $724K |
| Upadacitinib | 92 | $609K |
| Sarilumab | 96 | $412K |
| Secukinumab | 39 | $290K |
| Tocilizumab | 53 | $243K |
| Ixekizumab | 32 | $218K |
| Adalimumab | 31 | $214K |
| Tocilizumab | 35 | $168K |
| Voclosporin | 12 | $165K |
| Denosumab | 97 | $159K |
| Etanercept | 20 | $151K |
| Certolizumab Pegol | 24 | $151K |
Prescribing Profile
Patient Profile
71
Avg Age
79%
Female
1.49
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