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
2,720
Total Claims
$171K
Drug Cost
207
Beneficiaries
$827
Cost/Patient
Risk Score Breakdown 50/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+2000%
Opioid rate vs peers
79.4% vs 3.8% avg
-30%
Cost per patient vs peers
$827 vs $1,174 avg
+2%
Brand preference vs peers
9.0% 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 2,000% 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
79.4%
Opioid Rate
2,160
Opioid Claims
$131K
Opioid Cost
32.3%
Long-Acting Rate
This provider's opioid prescribing rate of 79.4% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 245 claims · $122K
Generic: 2,475 claims · $50K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 113 | $56K |
| Oxycodone Myristate | 28 | $21K |
| Naloxegol Oxalate | 18 | $12K |
| Oxycodone Hcl/Acetaminophen | 511 | $8,480 |
| Oxycodone Hcl | 364 | $6,991 |
| Gabapentin | 209 | $6,335 |
| Methadone Hcl | 286 | $5,279 |
| Fentanyl | 105 | $5,088 |
| Hydrocodone/Acetaminophen | 259 | $4,367 |
| Cyclobenzaprine Hcl | 98 | $2,119 |
| Morphine Sulfate | 148 | $2,049 |
| Pregabalin | 28 | $1,982 |
| Baclofen | 61 | $1,452 |
| Hydromorphone Hcl | 85 | $1,002 |
| Tramadol Hcl | 203 | $966 |
Prescribing Profile
20
Unique Drugs
50.0
Anomaly Score
Patient Profile
69
Avg Age
66%
Female
1.64
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