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 →Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
4,592
Total Claims
$273K
Drug Cost
471
Beneficiaries
$579
Cost/Patient
Risk Score Breakdown 50/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1702%
Opioid rate vs peers
68.2% vs 3.8% avg
-51%
Cost per patient vs peers
$579 vs $1,174 avg
-8%
Brand preference vs peers
8.1% 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 1,702% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 50/100 places this provider in the "High Risk" category — the top 0.017% of all Medicare Part D prescribers. Multiple independent risk factors are contributing simultaneously.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
68.2%
Opioid Rate
3,130
Opioid Claims
$214K
Opioid Cost
23.4%
Long-Acting Rate
This provider's opioid prescribing rate of 68.2% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 373 claims · $155K
Generic: 4,219 claims · $118K
Patient Profile
68
Avg Age
60%
Female
1.53
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About