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
7,026
Total Claims
$4.1M
Drug Cost
708
Beneficiaries
$5,826
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+435%
Opioid rate vs peers
21.7% vs 4.1% avg
-4%
Cost per patient vs peers
$5,826 vs $6,039 avg
+47%
Brand preference vs peers
11.2% 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 rate is 435% above Rheumatology peers. This is a significant deviation that may reflect a specialized patient population or concerning prescribing patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
21.7%
Opioid Rate
1,527
Opioid Claims
$129K
Opioid Cost
27.2%
Long-Acting Rate
This provider's opioid prescribing rate of 21.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 783 claims · $3.9M
Generic: 6,225 claims · $242K
Patient Profile
73
Avg Age
70%
Female
1.21
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