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
982
Total Claims
$42K
Drug Cost
220
Beneficiaries
$189
Cost/Patient
Risk Score Breakdown 31/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1245%
Opioid rate vs peers
42.1% vs 3.1% avg
-89%
Cost per patient vs peers
$189 vs $1,684 avg
-41%
Brand preference vs peers
5.6% 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 1,245% 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
42.1%
Opioid Rate
413
Opioid Claims
$20K
Opioid Cost
42.6%
Long-Acting Rate
This provider's opioid prescribing rate of 42.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 55 claims · $15K
Generic: 927 claims · $26K
Patient Profile
72
Avg Age
51%
Female
3.05
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