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
550
Total Claims
$632K
Drug Cost
61
Beneficiaries
$10K
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1126%
Opioid rate vs peers
46.4% vs 3.8% avg
+782%
Cost per patient vs peers
$10K vs $1,174 avg
+78%
Brand preference vs peers
15.8% vs 8.9% 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 1,126% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 782% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
46.4%
Opioid Rate
255
Opioid Claims
$23K
Opioid Cost
14.9%
Long-Acting Rate
This provider's opioid prescribing rate of 46.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 87 claims · $512K
Generic: 463 claims · $120K
Patient Profile
46
Avg Age
69%
Female
4.53
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