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
915
Total Claims
$1.0M
Drug Cost
59
Beneficiaries
$17K
Cost/Patient
Risk Score Breakdown 53/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1400%
Opioid rate vs peers
56.7% vs 3.8% avg
+1378%
Cost per patient vs peers
$17K vs $1,174 avg
+200%
Brand preference vs peers
26.6% 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 1,400% 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 1378% above the specialty average. Extreme cost outliers may indicate prescribing of unnecessarily expensive brand-name drugs or inappropriate drug utilization.
Composite risk score of 53/100 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
56.7%
Opioid Rate
519
Opioid Claims
$47K
Opioid Cost
33.9%
Long-Acting Rate
This provider's opioid prescribing rate of 56.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 243 claims · $1.0M
Generic: 672 claims · $24K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Deferiprone | 26 | $525K |
| Voxelotor | 36 | $342K |
| Oxycodone Hcl | 54 | $33K |
| Rivaroxaban | 25 | $22K |
| Apixaban | 36 | $21K |
| Deferasirox | 25 | $5,000 |
| Oxycodone Hcl | 243 | $2,280 |
| Naloxone Hcl | 18 | $1,612 |
| Morphine Sulfate | 36 | $1,300 |
| Methadone Hcl | 67 | $1,159 |
| Morphine Sulfate | 44 | $783 |
| Oxycodone Hcl/Acetaminophen | 17 | $506 |
| Omeprazole | 23 | $359 |
| Tizanidine Hcl | 11 | $338 |
| Lisinopril | 20 | $271 |
Prescribing Profile
Patient Profile
48
Avg Age
61%
Female
5.46
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