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
1,469
Total Claims
$514K
Drug Cost
40
Beneficiaries
$13K
Cost/Patient
Risk Score Breakdown 63/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1891%
Opioid rate vs peers
75.3% vs 3.8% avg
+993%
Cost per patient vs peers
$13K vs $1,174 avg
+316%
Brand preference vs peers
36.9% 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 1,891% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Cost per patient is 993% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Composite risk score of 63/100 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
75.3%
Opioid Rate
1,106
Opioid Claims
$207K
Opioid Cost
41.9%
Long-Acting Rate
This provider's opioid prescribing rate of 75.3% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 542 claims · $361K
Generic: 927 claims · $152K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Voxelotor | 21 | $243K |
| Oxycodone Hcl/Acetaminophen | 12 | $106K |
| Morphine Sulfate | 36 | $43K |
| Oxycodone Hcl | 253 | $27K |
| Rivaroxaban | 24 | $23K |
| Hydromorphone Hcl | 466 | $13K |
| Apixaban | 21 | $13K |
| Deferasirox | 11 | $9,187 |
| Morphine Sulfate | 122 | $5,567 |
| Fentanyl | 39 | $3,329 |
| Oxycodone Hcl | 123 | $2,775 |
| Hydroxyurea | 55 | $2,519 |
| Morphine Sulfate | 39 | $1,474 |
| Ondansetron | 11 | $466 |
| Amlodipine Besylate | 22 | $354 |
Prescribing Profile
Patient Profile
46
Avg Age
60%
Female
4.58
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