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 →31
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
226
Total Claims
$12K
Drug Cost
27
Beneficiaries
$461
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1330%
Opioid rate vs peers
44.7% vs 3.1% avg
-73%
Cost per patient vs peers
$461 vs $1,684 avg
+13%
Brand preference vs peers
10.6% 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 1,330% 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
44.7%
Opioid Rate
101
Opioid Claims
$7,237
Opioid Cost
34.7%
Long-Acting Rate
This provider's opioid prescribing rate of 44.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 24 claims · $4,086
Generic: 202 claims · $8,362
Patient Profile
70
Avg Age
—
Female
2.67
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