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 →29
🟡 Moderate
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
171
Total Claims
$6,494
Drug Cost
32
Beneficiaries
$203
Cost/Patient
Risk Score Breakdown 29/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1266%
Opioid rate vs peers
42.7% vs 3.1% avg
-88%
Cost per patient vs peers
$203 vs $1,684 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 1,266% 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
42.7%
Opioid Rate
73
Opioid Claims
$3,450
Opioid Cost
28.8%
Long-Acting Rate
This provider's opioid prescribing rate of 42.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 164 claims · $4,030
Patient Profile
67
Avg Age
—
Female
2.40
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