⚠️

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 →

Michelle BialaMSN, CRNP, AGACNP-BC

Nurse Practitioner · Philadelphia, PA 19106

NPI: 1205407822

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37

🟠 Elevated

Risk Flags

Very high opioid rate vs specialty peers90th percentile opioid prescribingHigh cost outlier (population + peer)High long-acting opioid rate vs peers

Risk indicators are statistical patterns, not allegations. Learn more

1,620

Total Claims

$1.3M

Drug Cost

202

Beneficiaries

$6,291

Cost/Patient

Risk Score Breakdown 37/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+18
Long-acting opioid rate+8
Cost per patient outlier+6
Opioid rate (national percentile)+5

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

+910%

Opioid rate vs peers

38.2% vs 3.8% avg

+436%

Cost per patient vs peers

$6,291 vs $1,174 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 910% above the average for Nurse Practitioner 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

38.2%

Opioid Rate

619

Opioid Claims

$123K

Opioid Cost

33.3%

Long-Acting Rate

This provider's opioid prescribing rate of 38.2% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

100% generic

Brand: 0 claims · $0

Generic: 1,306 claims · $254K

Patient Profile

58

Avg Age

55%

Female

4.15

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