Physician
Highlands Pediatrics
Highlands Pediatrics was paid $4.19M by Medicaid between Jan 2018 and Dec 2024, across 57 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 37% of everything it billed.
33Billing provider infoHIGHLANDS PEDIATRICS
ABINGDON, VA 24210
ABINGDON, VA 24210
33aNPI1427359090assigned 11/12/2010
33bProvider typePediatrics Physician
28Total paid$4.19M
24GClaims147,687
24DCodes billed57
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#41 of 817
Median peer was paid$29K
This provider vs. median143×
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 | 12,000 | $287K | |
| 2019 | 28,911 | $713K | |
| 2020 | 21,865 | $565K | |
| 2021 | 22,775 | $663K | |
| 2022 | 25,137 | $824K | |
| 2023 | 22,978 | $685K | |
| 2024incomplete | 14,021 | $455K |
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 | 37% | 27,078 | 23,942 | $1.57M |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 11% | 5,976 | 5,777 | $449K |
| 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 | 11% | 5,456 | 4,983 | $448K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 7.5% | 4,409 | 4,134 | $314K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 7.5% | 4,249 | 4,132 | $314K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.3% | 1,717 | 1,685 | $139K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 2.4% | 10,799 | 10,431 | $103K |
| 96127 | 1.7% | 11,870 | 9,734 | $70K | |
| 90686 | 1.5% | 5,508 | 5,318 | $61K | |
| 92551 | 1.4% | 6,334 | 6,095 | $58K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.3% | 4,281 | 3,978 | $55K |
| 99188 | 1.3% | 2,824 | 2,735 | $54K |
45 more codes
| 87428 | 1.2% | 1,525 | $52K | |
| 90670 | 1.2% | 3,037 | $49K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 1.1% | 1,946 | $46K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,102 | $41K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 1,434 | $39K |
| 83655 | <1% | 3,270 | $39K | |
| 90648 | <1% | 3,482 | $37K | |
| 90723 | <1% | 1,928 | $25K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 312 | $25K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 167 | $25K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,344 | $22K |
| 85018 | <1% | 8,453 | $19K | |
| 96160 | <1% | 11,840 | $19K | |
| 80061 | Lipid panel | <1% | 1,457 | $16K |
| 90651 | <1% | 682 | $15K | |
| 90633 | <1% | 956 | $11K | |
| 90677 | <1% | 377 | $11K | |
| 99173 | <1% | 4,595 | $10K | |
| 90734 | <1% | 432 | $7K | |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 103 | $6K |
| 81003 | <1% | 2,772 | $6K | |
| 90681 | <1% | 403 | $6K | |
| 90715 | <1% | 400 | $5K | |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 114 | $5K |
| 96161 | <1% | 2,570 | $4K | |
| 90620 | <1% | 136 | $3K | |
| 99381 | <1% | 27 | $2K | |
| 0071A | <1% | 60 | $2K | |
| 0072A | <1% | 48 | $2K | |
| 90710 | <1% | 136 | $2K | |
| 87807 | <1% | 140 | $2K | |
| 90696 | <1% | 103 | $1K | |
| 99383 | <1% | 13 | $1K | |
| 90716 | <1% | 39 | $893.15 | |
| 90707 | <1% | 39 | $707.17 | |
| 36416 | <1% | 1,584 | $679.42 | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 19 | $643.08 |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 13 | $576.70 |
| 90685 | <1% | 43 | $499.39 | |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 14 | $115.14 |
| 99177 | <1% | 16 | $43.14 | |
| 82962 | <1% | 13 | $29.98 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 14 | $27.90 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | <1% | 14 | $13.56 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | <1% | 14 | $0.36 |
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 officialDUNCAN, SONYA (OFFICE MANAGER)