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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 →

Karlene BertNURSE PRACTITIONER

Nurse Practitioner · Modesto, CA 95351

NPI: 1053511378

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13

🟢 Low

Risk Flags

High cost outlier (population + peer)Extreme fills per patient

Risk indicators are statistical patterns, not allegations. Learn more

10,126

Total Claims

$1.7M

Drug Cost

188

Beneficiaries

$9,233

Cost/Patient

Risk Score Breakdown 13/100

Low (0)Moderate (15)Elevated (30)High (50+)
Cost per patient outlier+6
High fills per patient+5

Score components are additive. Read full methodology

Peer Comparison vs. 218,535 Nurse Practitioner providers

-57%

Opioid rate vs peers

1.6% vs 3.8% avg

+686%

Cost per patient vs peers

$9,233 vs $1,174 avg

+132%

Brand preference vs peers

20.5% vs 8.9% avg

🔎 Data Overview

💰

Cost per patient is 686% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.

Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.

Opioid Prescribing

1.6%

Opioid Rate

163

Opioid Claims

$3,351

Opioid Cost

Long-Acting Rate

Brand vs Generic

80% generic

Brand: 2,064 claims · $1.5M

Generic: 7,984 claims · $191K

Top Prescribed Drugs

Drug (Generic)ClaimsCost
Tezepelumab-Ekko179$773K
Icosapent Ethyl315$111K
Dulaglutide89$86K
Exenatide Microspheres86$72K
Linaclotide98$52K
Fluticasone Propionate124$48K
Mirabegron101$47K
Rivaroxaban70$40K
Insulin Glargine,hum.Rec.Anlog114$39K
Apixaban56$33K
Dapagliflozin Propanediol49$29K
Fluticasone/Vilanterol50$21K
Empagliflozin/Metformin Hcl23$14K
Budesonide48$13K
Albuterol Sulfate212$13K

Prescribing Profile

119

Unique Drugs

$109K

IRA Negotiated Drugs

$86K

GLP-1 Drugs

13.0

Anomaly Score

Patient Profile

59

Avg Age

43%

Female

1.40

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