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
33,602
Total Claims
$9.0M
Drug Cost
2,164
Beneficiaries
$4,149
Cost/Patient
Risk Score Breakdown 9/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
-70%
Opioid rate vs peers
1.2% vs 4.1% avg
-31%
Cost per patient vs peers
$4,149 vs $6,039 avg
+10%
Brand preference vs peers
8.4% vs 7.6% 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
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
1.2%
Opioid Rate
411
Opioid Claims
$4,162
Opioid Cost
3.2%
Long-Acting Rate
Brand vs Generic
Brand: 2,815 claims · $8.6M
Generic: 30,770 claims · $407K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Adalimumab | 288 | $2.0M |
| Adalimumab | 267 | $2.0M |
| Upadacitinib | 164 | $1.0M |
| Etanercept | 124 | $886K |
| Etanercept | 103 | $723K |
| Tofacitinib Citrate | 56 | $315K |
| Abatacept | 54 | $294K |
| Secukinumab | 28 | $199K |
| Secukinumab | 27 | $190K |
| Etanercept | 26 | $182K |
| Abatacept | 23 | $125K |
| Golimumab | 12 | $74K |
| Sarilumab | 15 | $65K |
| Gabapentin | 5,263 | $51K |
| Adalimumab-Bwwd | 41 | $44K |
Prescribing Profile
Patient Profile
65
Avg Age
76%
Female
1.67
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