Holly Lowther, M.D.
Rheumatology Physician in Wexford, Pennsylvania. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers - including 6,181 in Rheumatology Physician, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration, see our methodology.
What the federal data shows
Holly Lowther, M.D. reported a CMS MIPS final score of 93.8/100 - above the 83.1 national average - and filed 2,680 Medicare Part D claims in 2023.
- 93.8/100
- MIPS score · +11 vs avg
- 3K
- Part D claims, 2023
- Likely
- board-certified (heuristic)
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) - no proprietary rating or editorial opinion is applied.
Holly Lowther, M.D.'s MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023, the federal quality measure
94 Top 29% higher than 71% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
Where Holly Lowther, M.D. sits
This provider among rheumatology physician peers
Across the 2,181 rheumatology physician providers who report both Medicare Part D prescribing and a MIPS quality score, Holly Lowther, M.D. writes more Part D claims than 66% of them and scores higher on MIPS quality than 74% - placing this provider in the high-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.
Part D claim volume vs MIPS quality, by specialty percentile
Each dot is one rheumatology physician peer from a representative sample of 60; the gold marker is Holly Lowther, M.D.. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.
Holly Lowther, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation - signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
What does the federal data show about Holly Lowther, M.D.?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Pennsylvania
How Rheumatology Physician compares to other specialties among Pennsylvania providers
Largest specialties in Pennsylvania (% of in-state providers)
Rheumatology Physician ranks #88 among Pennsylvania's specialties (0.1% of in-state providers)
Each bar is a specialty's share of the Pennsylvania provider total, by primary NUCC taxonomy. The highlighted bar is Rheumatology Physician; the long tail of smaller specialties is omitted for legibility.
Medicare quality performance, MIPS
Holly Lowther, M.D.'s 2023 MIPS final score plotted against the Rheumatology Physician national average
- MIPS Final Score
- 93.8/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Rheumatology Physician) - 93.8/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Specialty volume Rheumatology Physician US NPIs
93.8/100 MIPS final score - 10.7 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Rheumatology Physician. Quality dim: 85.1.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
Holly Lowther, M.D. appears in the CMS NPPES registry as a Rheumatology Physician provider holding M.D. credentials at 500 BLAZIER DR, Wexford, PA, 15090, with a listed phone of (412) 578-1152. NPI 1356377675 was issued on 06/26/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Lowther most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 2,680 prescription claims written by this provider, covering 549 Medicare beneficiaries and totaling roughly $2.3 million in drug spend, with an opioid prescribing rate of 3.7%. These figures capture only Medicare Part D, commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 93.8/100 for the 2023 performance year (Quality 85.1), compared with the national average of 83.1.
Rheumatology Physician is a mid-sized specialty nationwide, with 6,181 enrolled providers across 52 states and an average of 2,054 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist, always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1356377675 |
|---|---|
| Specialty | Rheumatology Physician |
| Credentials | M.D. |
| Gender | Female |
| NPI Issued | 06/26/2006 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm Holly Lowther, M.D.'s current license status, disciplinary history, and board certifications with the Pennsylvania State Board of Medicine in Pennsylvania before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where Holly Lowther, M.D. bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" - a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) - CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Holly Lowther, M.D.. Source: openpaymentsdata.cms.gov.
Total received
$455
Largest payer
Novartis Pharmaceuticals Corporation
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias, they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
License & disciplinary context - Pennsylvania PA-BOM 2023 annual report
Aggregate state board data only, NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~45K Pennsylvania medical licensees in 2023 - they are NOT specific to Holly Lowther, M.D.. To verify Holly Lowther, M.D.'s current license status, search the PA-BOM public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
PA-BOM publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Pennsylvania disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 5,349
- Total Day Supply
- 153,720
- Generic Drug Cost
- $117K
- Opioid Claims
- 98 (3.7% rate)
- Antibiotic Claims
- 44
Patient Demographics
- Average Patient Age
- 70.7 years
- Avg HCC Risk Score
- 1.44
- Gender Split
- 79% female / 21% male
- Age Distribution
- <65: 96, 65-74: 263, 75-84: 161, 85+: 29
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What Holly Lowther, M.D. prescribes most
Top Medicare Part D drugs by claim count, 2023
- Prednisone
Prednisone
348 claims
- Hydroxychloroquine…
Hydroxychloroquine Sulfate
318 claims
- Methotrexate
Methotrexate
223 claims
- Celecoxib 119
Celecoxib
119 claims
- Meloxicam 92
Meloxicam
92 claims
- Gabapentin 83
Gabapentin
83 claims
- Pregabalin 76
Pregabalin
76 claims
- Cyclobenzaprine Hcl 69
Cyclobenzaprine Hcl
69 claims
| Drug | Claims |
|---|---|
| Prednisone | 348 |
| Hydroxychloroquine Sulfate | 318 |
| Methotrexate Methotrexate Sodium | 223 |
| Celecoxib | 119 |
| Meloxicam | 92 |
| Gabapentin | 83 |
| Pregabalin | 76 |
| Cyclobenzaprine Hcl | 69 |
| Leflunomide | 66 |
| Diclofenac Sodium | 63 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Rheumatology Physician Overview
How Holly Lowther, M.D. fits within the Rheumatology Physician landscape nationally.
Holly Lowther, M.D.'s 2,680 claims are above the specialty average of 2,054.
Nearby Rheumatology Physician Providers in Pennsylvania
Other clinicians with the same primary specialty enrolled in Pennsylvania, drawn from the same CMS NPPES roster as Lowther.
Compare Rheumatology Physician nationally: see state-by-state distribution →
Before you book an appointment
Use this federal record as your verification checklist, not as a recommendation.
- Confirm the NPI record is current in the official CMS registry, providers update their own NPPES details, and moves can lag. Verify this NPI
- Check the active license and any disciplinary history with the Pennsylvania medical board, federal registration is not a license check. Credential verification guide
- Weigh a second option: compare this provider with a nearby Rheumatology Physician peer on Medicare volume and prescribing patterns. Compare providers
Medicare Part D and MIPS figures describe practice patterns in federal programs only, they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.
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Frequently Asked Questions
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) - 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology