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 →33
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
4,203
Total Claims
$670K
Drug Cost
540
Beneficiaries
$1,241
Cost/Patient
Risk Score Breakdown 33/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1352%
Opioid rate vs peers
45.4% vs 3.1% avg
-26%
Cost per patient vs peers
$1,241 vs $1,684 avg
+78%
Brand preference vs peers
16.8% vs 9.4% 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 1,352% 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
45.4%
Opioid Rate
1,908
Opioid Claims
$464K
Opioid Cost
37.2%
Long-Acting Rate
This provider's opioid prescribing rate of 45.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 698 claims · $502K
Generic: 3,468 claims · $166K
Patient Profile
72
Avg Age
62%
Female
1.34
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