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
4,887
Total Claims
$2.0M
Drug Cost
405
Beneficiaries
$4,890
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+599%
Opioid rate vs peers
28.4% vs 4.1% avg
-19%
Cost per patient vs peers
$4,890 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 prescribing rate is 599% 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
28.4%
Opioid Rate
1,388
Opioid Claims
$130K
Opioid Cost
18.7%
Long-Acting Rate
This provider's opioid prescribing rate of 28.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 4,406 claims · $184K
Patient Profile
71
Avg Age
82%
Female
1.87
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