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
212
Total Claims
$2,657
Drug Cost
137
Beneficiaries
$19
Cost/Patient
Risk Score Breakdown 21/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+761%
Opioid rate vs peers
32.5% vs 3.8% avg
-98%
Cost per patient vs peers
$19 vs $1,174 avg
🔎 Data Overview
Opioid prescribing rate is 761% 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 5 unique drugs with a 32.5% 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
32.5%
Opioid Rate
69
Opioid Claims
$352
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 32.5% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 206 claims · $2,634
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Methylprednisolone | 58 | $595 |
| Cephalexin | 23 | $296 |
| Gabapentin | 11 | $276 |
| Oxycodone Hcl/Acetaminophen | 46 | $220 |
| Hydrocodone/Acetaminophen | 19 | $107 |
Prescribing Profile
5
Unique Drugs
21.0
Anomaly Score
Patient Profile
73
Avg Age
56%
Female
1.16
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