Physician
High Risk Obstetrical Consultants, PLLC
High Risk Obstetrical Consultants, PLLC was paid $32.70M by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is 76819, Fetal biophysical profile; without non-stress testing — 21% of everything it billed.
33Billing provider infoHIGH RISK OBSTETRICAL CONSULTANTS, PLLC
KNOXVILLE, TN 37920
KNOXVILLE, TN 37920
33aNPI1770724676assigned 03/23/2009
33bProvider typeMaternal & Fetal Medicine Physician
28Total paid$32.70M
24GClaims430,457
24DCodes billed42
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Maternal & Fetal Medicine Physician providers in Tennessee
Rank by total paid#2 of 12
Median peer was paid$251K
This provider vs. median130×
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 | 44,786 | $2.91M | |
| 2019 | 54,685 | $3.90M | |
| 2020 | 63,330 | $4.65M | |
| 2021 | 67,326 | $5.33M | |
| 2022 | 66,211 | $5.26M | |
| 2023 | 67,945 | $5.65M | |
| 2024incomplete | 66,174 | $4.98M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 76819 | Fetal biophysical profile; without non-stress testing | 21% | 77,823 | 54,085 | $6.71M |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | 15% | 56,052 | 45,479 | $4.93M |
| 76820 | 15% | 73,772 | 50,326 | $4.79M | |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 13% | 22,680 | 19,751 | $4.34M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 9.9% | 52,062 | 40,731 | $3.24M |
| 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 | 7.6% | 26,891 | 21,957 | $2.49M |
| 76821 | 4.1% | 15,651 | 9,730 | $1.35M | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | 3.1% | 11,333 | 9,523 | $1.02M |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.5% | 8,113 | 6,881 | $808K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.2% | 5,120 | 4,473 | $732K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 1.2% | 5,878 | 4,434 | $401K |
| 76801 | <1% | 2,956 | 2,428 | $312K |
30 more codes
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 4,467 | $307K |
| 76813 | <1% | 2,038 | $196K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,300 | $162K |
| 59514 | <1% | 145 | $134K | |
| 81003 | <1% | 52,779 | $129K | |
| 99205 | Prolong outpt/office vis | <1% | 575 | $102K |
| 59409 | Vaginal delivery only (with or without episiotomy and/or forceps) | <1% | 105 | $101K |
| 59025 | Fetal non-stress test | <1% | 2,270 | $101K |
| 76825 | <1% | 341 | $64K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 658 | $61K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,323 | $46K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 284 | $37K |
| 76818 | <1% | 433 | $29K | |
| 76827 | <1% | 347 | $24K | |
| 93325 | <1% | 351 | $20K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,472 | $17K |
| 90715 | <1% | 301 | $12K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 156 | $10K |
| 59430 | <1% | 58 | $9K | |
| 99406 | <1% | 569 | $6K | |
| 90656 | <1% | 483 | $5K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 119 | $2K |
| 90686 | <1% | 24 | $530.31 | |
| 99201 | <1% | 12 | $395.40 | |
| T1013 | Sign language or oral interpretive services, per 15 minutes | <1% | 33 | $360.00 |
| 99407 | <1% | 12 | $343.63 | |
| 90674 | <1% | 14 | $308.40 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 78 | $177.79 |
| 99000 | <1% | 74 | $22.72 | |
| 0502F | 0% | 1,305 | $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 officialHENNESSY, MARK (OWNER)