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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 →

Pooja Shah

Nurse Practitioner · Crystal Lake, IL 60014

NPI: 1558951731

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39

🟠 Elevated

Risk Flags

Extreme opioid rate vs specialty peers95th percentile opioid prescribingElevated long-acting opioid rate

Risk indicators are statistical patterns, not allegations. Learn more

961

Total Claims

$61K

Drug Cost

235

Beneficiaries

$261

Cost/Patient

Risk Score Breakdown 39/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+25
Opioid rate (national percentile)+10
Long-acting opioid rate+4

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

+1611%

Opioid rate vs peers

64.7% vs 3.8% avg

-78%

Cost per patient vs peers

$261 vs $1,174 avg

-44%

Brand preference vs peers

5.0% 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 1,611% 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

64.7%

Opioid Rate

622

Opioid Claims

$49K

Opioid Cost

17.2%

Long-Acting Rate

This provider's opioid prescribing rate of 64.7% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

95% generic

Brand: 48 claims · $28K

Generic: 913 claims · $34K

Patient Profile

63

Avg Age

60%

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