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 →36
🟠 Elevated
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
215
Total Claims
$10K
Drug Cost
85
Beneficiaries
$118
Cost/Patient
Risk Score Breakdown 36/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+1656%
Opioid rate vs peers
54.9% vs 3.1% avg
-93%
Cost per patient vs peers
$118 vs $1,684 avg
-1%
Brand preference vs peers
9.3% 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 1,656% 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
54.9%
Opioid Rate
118
Opioid Claims
$6,874
Opioid Cost
45.8%
Long-Acting Rate
This provider's opioid prescribing rate of 54.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 20 claims · $4,840
Generic: 195 claims · $5,202
Patient Profile
71
Avg Age
61%
Female
2.95
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