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
3,498
Total Claims
$1.3M
Drug Cost
311
Beneficiaries
$4,065
Cost/Patient
Risk Score Breakdown 42/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+912%
Opioid rate vs peers
41.1% vs 4.1% avg
-33%
Cost per patient vs peers
$4,065 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 912% 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
41.1%
Opioid Rate
1,438
Opioid Claims
$48K
Opioid Cost
1.6%
Long-Acting Rate
This provider's opioid prescribing rate of 41.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 3,248 claims · $94K
Patient Profile
66
Avg Age
72%
Female
2.06
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