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
4,216
Total Claims
$1.8M
Drug Cost
204
Beneficiaries
$8,612
Cost/Patient
Risk Score Breakdown 46/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+759%
Opioid rate vs peers
34.9% vs 4.1% avg
+43%
Cost per patient vs peers
$8,612 vs $6,039 avg
+33%
Brand preference vs peers
10.1% 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 759% 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
34.9%
Opioid Rate
1,470
Opioid Claims
$215K
Opioid Cost
22.4%
Long-Acting Rate
This provider's opioid prescribing rate of 34.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 422 claims · $1.6M
Generic: 3,748 claims · $176K
Patient Profile
65
Avg Age
80%
Female
1.79
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