⚠️

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 →

Madison HigginsPA-C

Physician Assistant · Wilmington, NC 28412

NPI: 1114484946

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43

🟠 Elevated

Risk Flags

Very high opioid rate vs specialty peers99th percentile opioid prescribingHigh long-acting opioid rate vs peers

Risk indicators are statistical patterns, not allegations. Learn more

2,287

Total Claims

$242K

Drug Cost

219

Beneficiaries

$1,104

Cost/Patient

Risk Score Breakdown 43/100

Low (0)Moderate (15)Elevated (30)High (50+)
Opioid rate vs specialty peers+18
Opioid rate (national percentile)+15
Long-acting opioid rate+8

Score components are additive. Read full methodology

Peer Comparison vs. 109,535 Physician Assistant providers

+700%

Opioid rate vs peers

73.5% vs 9.2% avg

+54%

Cost per patient vs peers

$1,104 vs $719 avg

+109%

Brand preference vs peers

13.9% vs 6.7% 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 700% above the average for Physician Assistant providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.

Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.

Opioid Prescribing

73.5%

Opioid Rate

1,682

Opioid Claims

$214K

Opioid Cost

34.1%

Long-Acting Rate

This provider's opioid prescribing rate of 73.5% is above the 20% threshold that CMS considers elevated.

Brand vs Generic

86% generic

Brand: 318 claims · $176K

Generic: 1,969 claims · $66K

Patient Profile

69

Avg Age

64%

Female

1.45

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.Methodology · About