It has been proposed that the azimuthal distributions of heavy flavor quark-antiquark pairs may be modified in the medium of a heavy-ion collision. This assumption is tested through next-to-leading order (NLO) calculations of the azimuthal distribution, $d\sigma/d\phi$, including transverse momentum broadening, employing $\langle k_T^2 \rangle$ and fragmentation in exclusive $Q \overline Q$ pair production. The differences between NLO calculations and heavy $Q \overline Q$ pair production in event generators are also discusssed.