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
12,017
Total Claims
$2.7M
Drug Cost
714
Beneficiaries
$3,807
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+425%
Opioid rate vs peers
21.3% vs 4.1% avg
-37%
Cost per patient vs peers
$3,807 vs $6,039 avg
-10%
Brand preference vs peers
6.8% 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 425% 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
21.3%
Opioid Rate
2,562
Opioid Claims
$182K
Opioid Cost
13.2%
Long-Acting Rate
This provider's opioid prescribing rate of 21.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 822 claims · $2.3M
Generic: 11,181 claims · $408K
Patient Profile
71
Avg Age
80%
Female
1.54
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