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
3,409
Total Claims
$2.0M
Drug Cost
396
Beneficiaries
$5,109
Cost/Patient
Risk Score Breakdown 35/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+829%
Opioid rate vs peers
37.7% vs 4.1% avg
-15%
Cost per patient vs peers
$5,109 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 829% 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
37.7%
Opioid Rate
1,286
Opioid Claims
$109K
Opioid Cost
8.4%
Long-Acting Rate
This provider's opioid prescribing rate of 37.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 3,158 claims · $82K
Patient Profile
71
Avg Age
59%
Female
1.30
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