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
5,335
Total Claims
$392K
Drug Cost
526
Beneficiaries
$745
Cost/Patient
Risk Score Breakdown 45/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1361%
Opioid rate vs peers
55.3% vs 3.8% avg
-37%
Cost per patient vs peers
$745 vs $1,174 avg
+10%
Brand preference vs peers
9.7% 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 1,361% 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
55.3%
Opioid Rate
2,948
Opioid Claims
$181K
Opioid Cost
16.8%
Long-Acting Rate
This provider's opioid prescribing rate of 55.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 520 claims · $266K
Generic: 4,815 claims · $126K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 228 | $85K |
| Methylnaltrexone Bromide | 26 | $65K |
| Naloxegol Oxalate | 71 | $35K |
| Oxycodone Hcl/Acetaminophen | 1,004 | $35K |
| Linaclotide | 30 | $22K |
| Hydrocodone/Acetaminophen | 763 | $20K |
| Lidocaine | 35 | $19K |
| Gabapentin | 652 | $10K |
| Diclofenac Sodium | 262 | $9,098 |
| Pregabalin | 337 | $8,856 |
| Oxycodone Hcl | 462 | $8,591 |
| Lubiprostone | 21 | $7,599 |
| Tapentadol Hcl | 12 | $7,280 |
| Oxycodone Hcl | 27 | $6,000 |
| Lidocaine | 48 | $5,202 |
Prescribing Profile
33
Unique Drugs
45.0
Anomaly Score
Patient Profile
67
Avg Age
67%
Female
1.67
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