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
2,387
Total Claims
$1.8M
Drug Cost
480
Beneficiaries
$3,755
Cost/Patient
Risk Score Breakdown 32/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+916%
Opioid rate vs peers
41.3% vs 4.1% avg
-38%
Cost per patient vs peers
$3,755 vs $6,039 avg
+65%
Brand preference vs peers
12.5% 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 prescribing rate is 916% above the average for Rheumatology providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
41.3%
Opioid Rate
985
Opioid Claims
$21K
Opioid Cost
2.9%
Long-Acting Rate
This provider's opioid prescribing rate of 41.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 291 claims · $1.7M
Generic: 2,029 claims · $56K
Patient Profile
72
Avg Age
68%
Female
2.02
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