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
9,479
Total Claims
$2.6M
Drug Cost
427
Beneficiaries
$5,988
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+446%
Opioid rate vs peers
22.2% vs 4.1% avg
-1%
Cost per patient vs peers
$5,988 vs $6,039 avg
+24%
Brand preference vs peers
9.4% vs 7.6% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
Opioid rate is 446% 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
22.2%
Opioid Rate
2,101
Opioid Claims
$152K
Opioid Cost
29.3%
Long-Acting Rate
This provider's opioid prescribing rate of 22.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 876 claims · $2.1M
Generic: 8,459 claims · $396K
Patient Profile
69
Avg Age
79%
Female
1.48
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