Physician
Highroad Pediatrics
Highroad Pediatrics was paid $4.43M by Medicaid between Jan 2018 and Dec 2024, across 37 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 31% of everything it billed.
33Billing provider infoHIGHROAD PEDIATRICS
WINSTON SALEM, NC 27103
WINSTON SALEM, NC 27103
33aNPI1154348597assigned 07/15/2006
33bProvider typePediatrics Physician
28Total paid$4.43M
24GClaims212,021
24DCodes billed37
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in North Carolina
Rank by total paid#89 of 433
Median peer was paid$942K
This provider vs. median4.7×
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.
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 | |
|---|---|---|---|
| 2018 | 11,509 | $416K | |
| 2019 | 10,677 | $433K | |
| 2020 | 8,683 | $377K | |
| 2021 | 22,960 | $650K | |
| 2022 | 48,490 | $899K | |
| 2023 | 50,123 | $795K | |
| 2024incomplete | 59,579 | $856K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 31% | 15,368 | 13,009 | $1.38M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 25% | 18,319 | 15,711 | $1.12M |
| 99199 | Unlisted special service, procedure or report | 16% | 128,056 | 86,860 | $698K |
| 87633 | Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets | 7.7% | 1,499 | 1,249 | $339K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.9% | 9,319 | 7,992 | $174K |
| 99401 | 3.6% | 4,613 | 3,759 | $160K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.9% | 1,487 | 1,339 | $128K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.4% | 1,183 | 987 | $108K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.7% | 2,628 | 2,246 | $73K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.1% | 529 | 483 | $47K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.1% | 3,565 | 3,248 | $47K |
| 96127 | 1.0% | 11,176 | 9,632 | $46K |
25 more codes
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 209 | $26K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 1,017 | $20K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,028 | $10K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 245 | $9K |
| 99051 | <1% | 363 | $9K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 93 | $8K |
| 96160 | <1% | 1,325 | $4K | |
| 81003 | <1% | 1,849 | $3K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,000 | $3K |
| 90686 | <1% | 2,346 | $2K | |
| 69210 | <1% | 34 | $1K | |
| G0315 | Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt) | <1% | 34 | $1K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 28 | $927.02 |
| G0312 | Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) | <1% | 23 | $707.71 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 55 | $620.98 |
| D1206 | Topical application of fluoride varnish | <1% | 28 | $422.36 |
| 90651 | <1% | 33 | $420.48 | |
| 99173 | <1% | 2,358 | $301.01 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 29 | $220.34 |
| 92551 | <1% | 1,894 | $211.38 | |
| 94664 | <1% | 13 | $144.69 | |
| 96161 | <1% | 13 | $47.16 | |
| 90656 | <1% | 215 | $39.11 | |
| 90670 | 0% | 35 | $0.00 | |
| 90698 | 0% | 12 | $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 officialTOLLEY, SCOTT (OFFICE MANAGER)