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
10,140
Total Claims
$572K
Drug Cost
750
Beneficiaries
$763
Cost/Patient
Risk Score Breakdown 54/100
Score components are additive. Read full methodology
Peer Comparison vs. 218,535 Nurse Practitioner providers
+1621%
Opioid rate vs peers
65.1% vs 3.8% avg
-35%
Cost per patient vs peers
$763 vs $1,174 avg
-41%
Brand preference vs peers
5.2% 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 1,621% 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 54/100 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
65.1%
Opioid Rate
6,601
Opioid Claims
$440K
Opioid Cost
17.5%
Long-Acting Rate
This provider's opioid prescribing rate of 65.1% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 531 claims · $275K
Generic: 9,609 claims · $298K
Top Prescribed Drugs
| Drug (Generic) | Claims | Cost |
|---|---|---|
| Oxycodone Hcl | 217 | $126K |
| Hydrocodone/Acetaminophen | 2,099 | $64K |
| Tapentadol Hcl | 49 | $62K |
| Oxycodone Hcl | 1,523 | $43K |
| Oxycodone Hcl/Acetaminophen | 991 | $36K |
| Buprenorphine Hcl/Naloxone Hcl | 68 | $31K |
| Oxycodone Myristate | 54 | $28K |
| Morphine Sulfate | 495 | $16K |
| Buprenorphine Hcl | 18 | $16K |
| Fentanyl | 175 | $15K |
| Buprenorphine Hcl | 267 | $14K |
| Buprenorphine | 50 | $14K |
| Gabapentin | 570 | $9,540 |
| Tizanidine Hcl | 569 | $7,428 |
| Naloxegol Oxalate | 19 | $7,070 |
Prescribing Profile
43
Unique Drugs
54.0
Anomaly Score
Patient Profile
67
Avg Age
58%
Female
1.46
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