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
2,642
Total Claims
$1.1M
Drug Cost
600
Beneficiaries
$1,832
Cost/Patient
Risk Score Breakdown 37/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+1107%
Opioid rate vs peers
49.0% vs 4.1% avg
-70%
Cost per patient vs peers
$1,832 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 1,107% 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
49.0%
Opioid Rate
1,295
Opioid Claims
$46K
Opioid Cost
4.6%
Long-Acting Rate
This provider's opioid prescribing rate of 49.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 2,291 claims · $56K
Patient Profile
77
Avg Age
70%
Female
1.60
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