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
11,344
Total Claims
$1.3M
Drug Cost
783
Beneficiaries
$1,686
Cost/Patient
Risk Score Breakdown 51/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1297%
Opioid rate vs peers
52.8% vs 3.8% avg
+44%
Cost per patient vs peers
$1,686 vs $1,174 avg
+43%
Brand preference vs peers
12.6% vs 8.9% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
⚠️ Opioid + Benzodiazepine Co-Prescriber
This provider prescribes both opioids and benzodiazepines. The FDA has issued a Black Box Warning about the life-threatening risks of concurrent use.
🔎 Data Overview
Opioid prescribing rate is 1,297% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
This provider co-prescribes opioids and benzodiazepines — a combination carrying an FDA Black Box Warning due to increased risk of respiratory depression and death. While sometimes clinically necessary, this combination requires careful justification.
Composite risk score of 51/100 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
52.8%
Opioid Rate
5,994
Opioid Claims
$920K
Opioid Cost
42.1%
Long-Acting Rate
This provider's opioid prescribing rate of 52.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 1,435 claims · $831K
Generic: 9,909 claims · $489K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Myristate | 361 | $214K |
| Hydrocodone Bitartrate | 299 | $144K |
| Hydrocodone Bitartrate | 318 | $136K |
| Buprenorphine | 500 | $129K |
| Lidocaine | 117 | $61K |
| Tapentadol Hcl | 59 | $60K |
| Buprenorphine | 104 | $59K |
| Buprenorphine Hcl | 100 | $53K |
| Hydrocodone/Acetaminophen | 2,247 | $42K |
| Lidocaine | 175 | $36K |
| Methylnaltrexone Bromide | 14 | $34K |
| Gabapentin | 1,462 | $31K |
| Naloxegol Oxalate | 50 | $26K |
| Tapentadol Hcl | 32 | $24K |
| Naldemedine Tosylate | 46 | $23K |
Prescribing Profile
42
Unique Drugs
51.0
Anomaly Score
Patient Profile
70
Avg Age
70%
Female
1.57
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