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
4,632
Total Claims
$4.0M
Drug Cost
421
Beneficiaries
$9,469
Cost/Patient
Risk Score Breakdown 30/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+438%
Opioid rate vs peers
21.8% vs 4.1% avg
+57%
Cost per patient vs peers
$9,469 vs $6,039 avg
+78%
Brand preference vs peers
13.5% 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 438% 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
21.8%
Opioid Rate
1,011
Opioid Claims
$57K
Opioid Cost
17.5%
Long-Acting Rate
This provider's opioid prescribing rate of 21.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 626 claims · $3.8M
Generic: 4,006 claims · $148K
Patient Profile
70
Avg Age
76%
Female
1.82
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