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
2,256
Total Claims
$1.9M
Drug Cost
450
Beneficiaries
$4,287
Cost/Patient
Risk Score Breakdown 27/100
Score components are additive. Read full methodology
Peer Comparison vs. 5,101 Rheumatology providers
+541%
Opioid rate vs peers
26.0% vs 4.1% avg
-29%
Cost per patient vs peers
$4,287 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 541% 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
26.0%
Opioid Rate
587
Opioid Claims
$18K
Opioid Cost
17.7%
Long-Acting Rate
This provider's opioid prescribing rate of 26.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 1,815 claims · $61K
Patient Profile
73
Avg Age
82%
Female
1.83
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 of wrongdoing.Methodology · About · Dispute this data