Physician
Highland Pediatrics
Highland Pediatrics was paid $8.15M by Medicaid between Jan 2018 and Dec 2024, across 78 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.
33Billing provider infoHIGHLAND PEDIATRICS
FALL RIVER, MA 02720
FALL RIVER, MA 02720
33aNPI1619009792assigned 03/12/2007
33bProvider typePediatrics Physician
28Total paid$8.15M
24GClaims386,169
24DCodes billed78
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Massachusetts
Rank by total paid#3 of 1,273
Median peer was paid$24K
This provider vs. median340×
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 | 46,305 | $1.41M | |
| 2019 | 48,536 | $1.42M | |
| 2020 | 49,728 | $1.30M | |
| 2021 | 61,021 | $1.29M | |
| 2022 | 68,803 | $1.39M | |
| 2023 | 60,535 | $762K | |
| 2024incomplete | 51,241 | $574K |
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 | 24% | 42,477 | 40,779 | $1.96M |
| 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 | 21% | 25,757 | 24,863 | $1.72M |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 10% | 12,690 | 12,162 | $835K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 8.3% | 10,180 | 10,148 | $675K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 6.3% | 26,563 | 26,169 | $516K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.3% | 6,476 | 6,457 | $431K |
| S0302 | Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) | 4.9% | 42,751 | 41,907 | $402K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.2% | 29,703 | 25,182 | $264K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 2.0% | 2,000 | 1,978 | $165K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.0% | 2,110 | 2,101 | $160K |
| 99051 | 1.6% | 9,267 | 9,133 | $127K | |
| 87634 | 1.5% | 2,000 | 1,978 | $123K |
66 more codes
| 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 | 1.5% | 1,927 | $121K |
| 90461 | 1.4% | 15,449 | $118K | |
| 87430 | 1.0% | 6,522 | $85K | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 5,970 | $73K |
| 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% | 1,927 | $47K |
| 99188 | <1% | 1,705 | $45K | |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,405 | $43K |
| 94760 | <1% | 20,571 | $42K | |
| 83655 | <1% | 3,069 | $34K | |
| 96127 | <1% | 9,858 | $34K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,876 | $31K |
| T1015 | A visit at a community health center or clinic (one all-in rate) | <1% | 140 | $23K |
| 99401 | <1% | 311 | $6K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 153 | $6K |
| 85018 | <1% | 2,738 | $6K | |
| 85014 | <1% | 2,348 | $5K | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 156 | $4K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 156 | $4K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | <1% | 80 | $4K |
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | <1% | 65 | $4K |
| 99460 | <1% | 31 | $4K | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 490 | $3K |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 86 | $3K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 45 | $3K |
| 0072A | <1% | 62 | $3K | |
| 0071A | <1% | 53 | $2K | |
| 85046 | <1% | 467 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 17 | $2K |
| 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 | <1% | 14 | $584.92 |
| 96161 | <1% | 3,268 | $465.69 | |
| 99173 | <1% | 25 | $414.12 | |
| 99441 | <1% | 30 | $275.42 | |
| 99442 | <1% | 15 | $265.35 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 515 | $201.25 |
| 96160 | <1% | 22,058 | $195.48 | |
| 90651 | <1% | 80 | $173.11 | |
| 90686 | <1% | 10,038 | $140.08 | |
| 81002 | <1% | 52 | $139.32 | |
| 83718 | <1% | 12 | $101.40 | |
| 85027 | <1% | 14 | $79.94 | |
| 82465 | <1% | 12 | $53.76 | |
| 90688 | <1% | 56 | $37.01 | |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 12 | $1.20 |
| G9920 | Screening performed and negative | 0% | 911 | $0.00 |
| 99072 | 0% | 38,179 | $0.00 | |
| 90648 | 0% | 946 | $0.00 | |
| 90670 | 0% | 5,957 | $0.00 | |
| 90710 | 0% | 24 | $0.00 | |
| 90633 | 0% | 1,048 | $0.00 | |
| 90671 | 0% | 91 | $0.00 | |
| 90685 | 0% | 454 | $0.00 | |
| G9919 | Screening performed and positive and provision of recommendations | 0% | 13 | $0.00 |
| 90734 | 0% | 38 | $0.00 | |
| 90707 | 0% | 13 | $0.00 | |
| 90698 | 0% | 1,514 | $0.00 | |
| 90680 | 0% | 3,341 | $0.00 | |
| 91307 | 0% | 175 | $0.00 | |
| 90723 | 0% | 914 | $0.00 | |
| 36416 | 0% | 5,333 | $0.00 | |
| 90677 | 0% | 883 | $0.00 | |
| 90697 | 0% | 305 | $0.00 | |
| 90744 | 0% | 113 | $0.00 | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | 0% | 15 | $0.00 |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 14 | $0.00 |
| 90716 | 0% | 24 | $0.00 | |
| 90696 | 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 officialSIEGEL, WAYNE (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| The Center for Gastroenterology and Liver Disorders LLC | Secaucus, NJ | $80K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.