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 →55
🔴 High Risk
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
5,532
Total Claims
$195K
Drug Cost
310
Beneficiaries
$629
Cost/Patient
Risk Score Breakdown 55/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1589%
Opioid rate vs peers
63.9% vs 3.8% avg
-46%
Cost per patient vs peers
$629 vs $1,174 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 1,589% above the average for Nurse Practitioner providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 55/100 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
63.9%
Opioid Rate
3,535
Opioid Claims
$127K
Opioid Cost
23.1%
Long-Acting Rate
This provider's opioid prescribing rate of 63.9% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 0 claims · $0
Generic: 5,360 claims · $149K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Hydrocodone/Acetaminophen | 739 | $25K |
| Oxycodone Hcl | 1,002 | $20K |
| Buprenorphine | 43 | $19K |
| Oxycodone Hcl/Acetaminophen | 500 | $15K |
| Oxycodone Hcl | 24 | $12K |
| Morphine Sulfate | 547 | $12K |
| Naloxegol Oxalate | 12 | $7,925 |
| Pregabalin | 188 | $6,876 |
| Gabapentin | 314 | $6,479 |
| Oxycodone Myristate | 11 | $6,008 |
| Naloxone Hcl | 62 | $5,499 |
| Buprenorphine Hcl/Naloxone Hcl | 34 | $5,051 |
| Tramadol Hcl | 50 | $3,995 |
| Tizanidine Hcl | 288 | $3,752 |
| Buprenorphine Hcl | 50 | $3,382 |
Prescribing Profile
41
Unique Drugs
55.0
Anomaly Score
Patient Profile
70
Avg Age
64%
Female
1.69
Avg Risk Score
Explore More
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