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
2,551
Total Claims
$2.1M
Drug Cost
201
Beneficiaries
$11K
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+445%
Opioid rate vs peers
22.1% vs 4.1% avg
+75%
Cost per patient vs peers
$11K 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 rate is 445% 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
22.1%
Opioid Rate
564
Opioid Claims
$15K
Opioid Cost
28.5%
Long-Acting Rate
This provider's opioid prescribing rate of 22.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 2,148 claims · $72K
Patient Profile
71
Avg Age
74%
Female
1.61
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