Physician
Highgate Medical Group
Highgate Medical Group was paid $172K by Medicaid between Jan 2018 and Nov 2024, across 22 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 63% of everything it billed.
33Billing provider infoHIGHGATE MEDICAL GROUP
AMHERST, NY 14228
AMHERST, NY 14228
33aNPI1326158593assigned 08/30/2006
33bProvider typeFamily Medicine Physician
28Total paid$172K
24GClaims11,669
24DCodes billed22
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in New York
Rank by total paid#439 of 2,605
Median peer was paid$10K
This provider vs. median17×
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 | 1,218 | $27K | |
| 2019 | 2,176 | $45K | |
| 2020 | 2,452 | $24K | |
| 2021 | 1,923 | $16K | |
| 2022 | 1,108 | $22K | |
| 2023 | 2,291 | $28K | |
| 2024incomplete | 501 | $9K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 63% | 4,487 | 4,353 | $108K |
| 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 | 18% | 851 | 833 | $31K |
| 99442 | 4.8% | 625 | 597 | $8K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 3.3% | 113 | 49 | $6K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.7% | 557 | 551 | $5K |
| 90688 | 2.6% | 282 | 280 | $4K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.1% | 112 | 112 | $4K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.7% | 81 | 81 | $3K |
| 96127 | 1.3% | 1,668 | 1,664 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 13 | 13 | $574.43 |
| 99441 | <1% | 56 | 51 | $482.26 | |
| 99443 | <1% | 42 | 41 | $404.69 |
10 more codes
| 99385 | <1% | 12 | $259.48 | |
| 3074F | <1% | 1,001 | $80.00 | |
| 94760 | <1% | 171 | $50.02 | |
| 3078F | <1% | 337 | $20.00 | |
| 3079F | <1% | 186 | $20.00 | |
| 99080 | 0% | 403 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 404 | $0.00 |
| 3016F | 0% | 203 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 53 | $0.00 |
| G8484 | Influenza immunization was not administered, reason not given | 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 officialPAWLOWSKI, DAVID (PRESIDENT)