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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 →

Sheila PhillipsCRNP

Nurse Practitioner · Washington, PA 15301

NPI: 1598335283

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38

🟠 Elevated

Risk Flags

Very high opioid rate vs specialty peers95th percentile opioid prescribingHigh long-acting opioid rate vs peers

Risk indicators are statistical patterns, not allegations. Learn more

3,487

Total Claims

$253K

Drug Cost

387

Beneficiaries

$653

Cost/Patient

Risk Score Breakdown 38/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+18
Opioid rate (national percentile)+10
Long-acting opioid rate+8

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

+1274%

Opioid rate vs peers

52.0% vs 3.8% avg

-44%

Cost per patient vs peers

$653 vs $1,174 avg

-12%

Brand preference vs peers

7.8% 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 1,274% 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

52.0%

Opioid Rate

1,812

Opioid Claims

$162K

Opioid Cost

27.0%

Long-Acting Rate

This provider's opioid prescribing rate of 52.0% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

92% generic

Brand: 273 claims · $130K

Generic: 3,214 claims · $123K

Patient Profile

67

Avg Age

59%

Female

1.80

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