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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 →

Gerald HoM.D.

Rheumatology · La Palma, CA 90623

NPI: 1205833662

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3

🟢 Low

Risk Flags

Elevated cost per beneficiary

Risk indicators are statistical patterns, not allegations. Learn more

20,586

Total Claims

$19.9M

Drug Cost

2,309

Beneficiaries

$8,605

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

-51%

Opioid rate vs peers

2.0% vs 4.1% avg

+42%

Cost per patient vs peers

$8,605 vs $6,039 avg

+176%

Brand preference vs peers

21.0% vs 7.6% avg

Opioid Prescribing

2.0%

Opioid Rate

410

Opioid Claims

$4,176

Opioid Cost

Long-Acting Rate

Brand vs Generic

79% generic

Brand: 4,303 claims · $18.5M

Generic: 16,235 claims · $1.4M

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Pegloticase42$2.4M
Adalimumab236$1.7M
Abatacept/Maltose335$1.3M
Infliximab223$1.2M
Immun Glob G(Igg)/Gly/Iga Ov5082$1.1M
Etanercept124$989K
Diclofenac Sodium2,308$926K
Upadacitinib134$897K
Golimumab119$852K
Belimumab232$681K
Denosumab380$629K
Tocilizumab210$615K
Abatacept101$586K
Rituximab23$438K
Teriparatide100$432K

Prescribing Profile

99

Unique Drugs

$1.2M

IRA Negotiated Drugs

3.0

Anomaly Score

Patient Profile

71

Avg Age

81%

Female

1.55

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