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 →50
🔴 High Risk
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
2,886
Total Claims
$178K
Drug Cost
507
Beneficiaries
$351
Cost/Patient
Risk Score Breakdown 50/100
Score components are additive. Read full methodology
Peer Comparison vs. 1,680 Certified Clinical Nurse Specialist providers
+2257%
Opioid rate vs peers
73.7% vs 3.1% avg
-79%
Cost per patient vs peers
$351 vs $1,684 avg
-47%
Brand preference vs peers
5.0% vs 9.4% 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 2,257% above the average for Certified Clinical Nurse Specialist providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Composite risk score of 50/100 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
73.7%
Opioid Rate
2,126
Opioid Claims
$149K
Opioid Cost
20.7%
Long-Acting Rate
This provider's opioid prescribing rate of 73.7% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 144 claims · $85K
Generic: 2,742 claims · $93K
Patient Profile
69
Avg Age
67%
Female
1.71
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