Physician
Highlands Ob-Gyn, PLLC
Highlands Ob-Gyn, PLLC was paid $9K by Medicaid between Mar 2018 and Dec 2020, across 16 billing codes. Its largest line is 76816, Ultrasound, pregnant uterus, real time with image documentation, follow-up — 30% of everything it billed.
33Billing provider infoHIGHLANDS OB-GYN, PLLC
COOKEVILLE, TN 38501
COOKEVILLE, TN 38501
33aNPI1174956957assigned 08/15/2013
33bProvider typeObstetrics & Gynecology Physician
28Total paid$9K
24GClaims1,460
24DCodes billed16
24AFirst – last monthMar 2018 – Dec 2020
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in Tennessee
Rank by total paid#114 of 176
Median peer was paid$39K
This provider vs. median0.2×
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 | 108 | $1K | |
| 2019 | 1,078 | $8K | |
| 2020 | 274 | $626.72 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 30% | 48 | 46 | $3K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 19% | 33 | 29 | $2K |
| 90674 | 14% | 58 | 54 | $1K | |
| 90715 | 12% | 26 | 25 | $1K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 30 | 24 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 6.4% | 147 | 132 | $609.39 |
| 80305 | 1.8% | 15 | 13 | $170.50 | |
| 0502F | 1.5% | 362 | 285 | $140.00 | |
| 0501F | 1.5% | 228 | 169 | $140.00 | |
| 82950 | 1.4% | 24 | 24 | $135.80 | |
| 85018 | <1% | 14 | 14 | $36.99 | |
| 0503F | <1% | 158 | 141 | $33.94 |
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 officialRIVERO, JOSE (OWNER/PHYSICIAN)