Clinic
Highlands Hospital and Health Center
Highlands Hospital and Health Center was paid $4.47M by Medicaid between Jan 2020 and Nov 2024, across 117 billing codes. Its largest line is G0480, Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed — 28% of everything it billed.
33Billing provider infoHIGHLANDS HOSPITAL AND HEALTH CENTER
CONNELLSVILLE, PA 15425
CONNELLSVILLE, PA 15425
33aNPI1144215039assigned 09/16/2005
33bProvider typeMulti-Specialty Clinic/Center
28Total paid$4.47M
24GClaims105,993
24DCodes billed117
24AFirst – last monthJan 2020 – Nov 2024
Compared with peers
Next to other Multi-Specialty Clinic/Center providers in Pennsylvania
Rank by total paid#2 of 14
Median peer was paid$98K
This provider vs. median46×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official STRISHOCK, JOURDAN controls 16+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2020 | 8,058 | $346K | |
| 2021 | 51,092 | $1.93M | |
| 2022 | 11,954 | $563K | |
| 2023 | 23,833 | $1.12M | |
| 2024incomplete | 11,056 | $517K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed | 28% | 20,572 | 18,367 | $1.24M |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | 21% | 14,254 | 12,808 | $944K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 15% | 5,750 | 5,595 | $650K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 9.3% | 5,445 | 5,313 | $418K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 5.1% | 1,368 | 1,309 | $226K |
| U0003 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r | 2.9% | 1,722 | 1,662 | $129K |
| 72148 | Magnetic resonance imaging, lumbar spine; without contrast material | 1.5% | 373 | 369 | $66K |
| G0378 | Hospital observation service, per hour | 1.2% | 56 | 55 | $54K |
| 80053 | Comprehensive metabolic panel | 1.2% | 6,645 | 6,382 | $54K |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 1.2% | 1,265 | 372 | $53K |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 1,114 | 1,094 | $42K |
| 87631 | <1% | 352 | 346 | $42K |
105 more codes
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 2,259 | $34K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,023 | $33K |
| 80061 | Lipid panel | <1% | 2,208 | $29K |
| 80050 | General health panel | <1% | 574 | $27K |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 960 | $27K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 137 | $26K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 5,823 | $24K |
| U0005 | Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 | <1% | 1,219 | $19K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 1,682 | $18K |
| 0002A | <1% | 403 | $17K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 515 | $16K |
| 70450 | Computed tomography, head or brain; without contrast material | <1% | 216 | $16K |
| 0001A | <1% | 414 | $15K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 1,441 | $13K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 393 | $13K |
| 85027 | <1% | 1,716 | $12K | |
| 83735 | <1% | 1,614 | $11K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 713 | $10K |
| 72141 | <1% | 39 | $10K | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 545 | $10K |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 1,047 | $9K |
| 74176 | Computed tomography, abdomen and pelvis; without contrast material | <1% | 87 | $9K |
| 77067 | Screening mammography, bilateral, including computer-aided detection | <1% | 110 | $9K |
| 84703 | <1% | 817 | $8K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 454 | $7K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 972 | $7K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 319 | $7K |
| 84484 | <1% | 728 | $6K | |
| 80320 | <1% | 460 | $5K | |
| 82607 | <1% | 374 | $5K | |
| 80329 | <1% | 367 | $5K | |
| 71045 | Radiologic examination, chest; single view | <1% | 702 | $5K |
| 81001 | <1% | 1,720 | $5K | |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 123 | $5K |
| 82043 | <1% | 530 | $4K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 145 | $4K |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 286 | $4K |
| 96413 | Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance | <1% | 49 | $4K |
| 83690 | <1% | 744 | $3K | |
| 82570 | <1% | 438 | $3K | |
| 85730 | <1% | 474 | $3K | |
| 85610 | <1% | 807 | $3K | |
| 84439 | <1% | 323 | $3K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 314 | $3K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 15-21 drug class(es), including metabolite(s) if performed | <1% | 20 | $2K |
| 82728 | <1% | 197 | $2K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | <1% | 109 | $2K |
| 86803 | <1% | 121 | $2K | |
| 73030 | <1% | 85 | $2K | |
| 83540 | <1% | 268 | $2K | |
| 83605 | <1% | 286 | $2K | |
| 96360 | Intravenous infusion, hydration; initial, 31 minutes to 1 hour | <1% | 71 | $2K |
| 80076 | <1% | 194 | $2K | |
| 73610 | <1% | 92 | $2K | |
| 72110 | <1% | 75 | $2K | |
| 84450 | <1% | 231 | $2K | |
| 73630 | <1% | 143 | $2K | |
| 84460 | <1% | 207 | $2K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,711 | $1K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 12 | $1K |
| 83550 | <1% | 231 | $1K | |
| 87340 | <1% | 56 | $804.96 | |
| 85379 | <1% | 81 | $804.52 | |
| 82746 | <1% | 66 | $788.28 | |
| 81003 | <1% | 251 | $777.89 | |
| 84153 | <1% | 30 | $743.58 | |
| 85007 | <1% | 204 | $725.09 | |
| 73564 | <1% | 30 | $661.47 | |
| 0003A | <1% | 15 | $652.40 | |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | <1% | 16 | $647.11 |
| 84436 | <1% | 63 | $586.90 | |
| 85652 | <1% | 182 | $558.33 | |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 12 | $519.14 |
| 82550 | <1% | 95 | $494.02 | |
| 88142 | <1% | 27 | $471.68 | |
| 84702 | <1% | 26 | $462.04 | |
| G0476 | Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test | <1% | 13 | $439.59 |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | <1% | 14 | $419.07 |
| 73130 | <1% | 35 | $403.15 | |
| 87040 | <1% | 16 | $362.18 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 44 | $336.62 |
| 82150 | <1% | 75 | $300.09 | |
| 87430 | <1% | 46 | $278.20 | |
| 87081 | <1% | 47 | $224.92 | |
| 82248 | <1% | 30 | $204.25 | |
| 73110 | <1% | 18 | $199.76 | |
| 84550 | <1% | 34 | $190.38 | |
| 86141 | <1% | 18 | $183.73 | |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 865 | $147.86 |
| 82565 | <1% | 27 | $147.22 | |
| 90714 | <1% | 40 | $126.00 | |
| 84520 | <1% | 26 | $124.88 | |
| 86140 | <1% | 38 | $114.27 | |
| 86593 | <1% | 13 | $79.61 | |
| 93041 | <1% | 13 | $49.30 | |
| J2704 | Injection, propofol, 10 mg | <1% | 193 | $36.10 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 483 | $34.68 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 232 | $25.38 |
| J3010 | Injection, fentanyl citrate, 0.1 mg | <1% | 16 | $3.40 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 45 | $2.04 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 0% | 125 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 18 | $0.00 |
| 87280 | 0% | 13 | $0.00 | |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 0% | 26 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 23 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSTRISHOCK, JOURDAN (COMPLIANCE ANALYST/ENROLLMENT SUPV)
Parent organizationPENN HIGHLANDS HEALTHCARE
| Provider | Location | Paid |
|---|---|---|
| Monongahela Valley Hospital, INC. | Monongahela, PA | $3.93M |
| Monongahela Valley Hospital, INC. | Monongahela, PA | $3.58M |
| Dubois Regional Medical Center | Clearfield, PA | $1.79M |
| Tyrone Hospital | Tyrone, PA | $1.44M |
| Penn Highlands Home Medical Equipment LLC | Clearfield, PA | $177K |
| Penn Highlands Home Medical Equipment LLC | Saint Marys, PA | $134K |
| Penn Highlands Home Medical Equipment LLC | Du Bois, PA | $29K |
| Highlands Hospital and Health Center | Connellsville, PA | $16K |
| Dubois Regional Medical Center | Du Bois, PA | $10K |
| J C Blair Memorial Hospital | State College, PA | $7K |
| Monongahela Valley Hospital, INC. | Monongahela, PA | $4K |
| JC Blair Memorial Hospital | Huntingdon, PA | $2K |
| Monongahela Valley Hospital, INC. | Monongahela, PA | $404.23 |
| J. C. Blair Memorial Hospital | Huntingdon, PA | $346.50 |
| Monongahela Valley Hospital, INC | Uniontown, PA | $320.93 |
| Mon-Vale Oncology, INC. | Monongahela, PA | $309.50 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.