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 →39
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
148
Total Claims
$6,517
Drug Cost
30
Beneficiaries
$217
Cost/Patient
Risk Score Breakdown 39/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1910%
Opioid rate vs peers
62.8% vs 3.1% avg
-87%
Cost per patient vs peers
$217 vs $1,684 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 1,910% above the average for Certified Clinical Nurse Specialist 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
62.8%
Opioid Rate
93
Opioid Claims
$5,569
Opioid Cost
32.3%
Long-Acting Rate
This provider's opioid prescribing rate of 62.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 139 claims · $4,654
Patient Profile
68
Avg Age
63%
Female
2.78
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