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 →49
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
5,792
Total Claims
$229K
Drug Cost
768
Beneficiaries
$298
Cost/Patient
Risk Score Breakdown 49/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1447%
Opioid rate vs peers
58.5% vs 3.8% avg
-75%
Cost per patient vs peers
$298 vs $1,174 avg
-76%
Brand preference vs peers
2.1% vs 8.9% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ Opioid + Benzodiazepine Co-Prescriber
This provider prescribes both opioids and benzodiazepines. The FDA has issued a Black Box Warning about the life-threatening risks of concurrent use.
🔎 Data Overview
Opioid prescribing rate is 1,447% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
58.5%
Opioid Rate
3,388
Opioid Claims
$143K
Opioid Cost
10.6%
Long-Acting Rate
This provider's opioid prescribing rate of 58.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 121 claims · $53K
Generic: 5,671 claims · $175K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 1,830 | $38K |
| Tapentadol Hcl | 19 | $35K |
| Oxycodone Hcl/Acetaminophen | 532 | $15K |
| Gabapentin | 557 | $13K |
| Lidocaine | 96 | $13K |
| Diclofenac Sodium | 216 | $11K |
| Duloxetine Hcl | 177 | $8,787 |
| Pregabalin | 289 | $7,258 |
| Buprenorphine | 34 | $7,146 |
| Hydrocodone Bitartrate | 12 | $6,519 |
| Buprenorphine Hcl/Naloxone Hcl | 44 | $6,425 |
| Fentanyl | 49 | $5,945 |
| Naloxone Hcl | 57 | $4,215 |
| Morphine Sulfate | 151 | $3,724 |
| Tramadol Hcl | 39 | $3,006 |
Prescribing Profile
38
Unique Drugs
49.0
Anomaly Score
Patient Profile
72
Avg Age
66%
Female
2.01
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