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
569
Total Claims
$30K
Drug Cost
72
Beneficiaries
$415
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1176%
Opioid rate vs peers
39.9% vs 3.1% avg
-75%
Cost per patient vs peers
$415 vs $1,684 avg
-5%
Brand preference vs peers
9.0% 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 1,176% 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
39.9%
Opioid Rate
227
Opioid Claims
$16K
Opioid Cost
37.9%
Long-Acting Rate
This provider's opioid prescribing rate of 39.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 51 claims · $13K
Generic: 518 claims · $17K
Patient Profile
67
Avg Age
57%
Female
3.32
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