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
50
Total Claims
$8,713
Drug Cost
20
Beneficiaries
$436
Cost/Patient
Risk Score Breakdown 10/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+640%
Opioid rate vs peers
28.0% vs 3.8% avg
-63%
Cost per patient vs peers
$436 vs $1,174 avg
+306%
Brand preference vs peers
36.0% vs 8.9% avg
🔎 Data Overview
Opioid prescribing rate is 640% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Prescribes only 2 unique drugs with a 28.0% opioid rate. Very low drug diversity combined with high opioid prescribing is a classic statistical marker of potential pill mill operations. However, some legitimate practices (e.g., addiction treatment with buprenorphine) can show similar patterns.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
28.0%
Opioid Rate
14
Opioid Claims
$53
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 28.0% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 18 claims · $7,512
Generic: 32 claims · $1,201
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Ticagrelor | 18 | $7,512 |
| Oxycodone Hcl | 13 | $47 |
Prescribing Profile
2
Unique Drugs
10.0
Anomaly Score
Patient Profile
70
Avg Age
—
Female
1.35
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 of wrongdoing.Methodology · About · Dispute this data