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
117
Total Claims
$1,687
Drug Cost
71
Beneficiaries
$24
Cost/Patient
Risk Score Breakdown 16/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+691%
Opioid rate vs peers
29.9% vs 3.8% avg
-98%
Cost per patient vs peers
$24 vs $1,174 avg
🔎 Data Overview
Opioid prescribing rate is 691% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 4 unique drugs with a 29.9% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
29.9%
Opioid Rate
35
Opioid Claims
$284
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 29.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 117 claims · $1,687
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Levetiracetam | 13 | $348 |
| Cyclobenzaprine Hcl | 15 | $201 |
| Oxycodone Hcl | 20 | $183 |
| Hydrocodone/Acetaminophen | 11 | $73 |
Prescribing Profile
4
Unique Drugs
16.0
Anomaly Score
Patient Profile
70
Avg Age
45%
Female
1.36
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