Medicare Enrolled
Dr. Donald Higgins, DO
Family Medicine · Westchester, IL
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
Very High
DATA COVERAGE
Data in 4 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Higgins from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
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What this data tells you about Dr. Higgins
Dr. Donald Higgins is a family medicine specialist in Westchester, IL, with 20 years of NPI registration. Based on federal Medicare data, Dr. Higgins performed 3,182 Medicare services in 2023. These records do not provide a deduplicated patient total.
Between the years covered by Open Payments, Dr. Higgins received a total of $2,575 from 22 pharmaceutical and/or device companies across 170 payment records. A record can group multiple payments. These transfers are publicly reported through CMS Open Payments. Disclosure alone does not establish their effect on care. A reliable breakdown by payment category is not available in this snapshot. Patients may wish to discuss these relationships with their provider.
The Data Coverage level for Dr. Higgins is Very High — reflecting how much public federal data is available about this provider. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 20 years of NPI registration
▲ Top 4% volume in IL
$2,575 industry payments
Medicare Practice Summary — 2023
Medicare Utilization ↗3,182
Medicare services
Top 4% in IL for family medicine
Not available
Unique patients (not deduplicated)
$48
Avg. Medicare payment
Medicare patients only (65+ / disabled) · How to read this →
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Denosumab injection (Prolia/Xgeva) | 1,320 | $18 | $30 |
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
375 | $84 | $255 |
| Advance care planning consultation, first 30 min A session focused on discussing and documenting future healthcare preferences and goals. This service covers the initial 30 minutes of the planning discussion. |
186 | $85 | $195 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
183 | $132 | $276 |
| Steroid injection (triamcinolone) A 10 mg injection of triamcinolone acetonide, a corticosteroid medication. This code specifies the drug and dosage administered. |
160 | $1 | $23 |
| Hemoglobin a1c level, by device for home use | 79 | $10 | $44 |
| Bone density scan (DEXA) A test that uses low-dose X-rays to measure bone mineral density in the hip, pelvis, and spine. It helps assess bone strength and risk of fractures. |
71 | $40 | $231 |
| Trabecular bone score interpretation Analysis of bone texture to assess fracture risk. The provider interprets the trabecular bone score and generates a report on the patient's risk of fractures. |
69 | $7 | $26 |
| Hospital follow-up visit, moderate complexity Follow-up hospital visit for an existing patient involving moderate medical decision making. The visit requires at least 35 minutes of time spent on the date of service. |
65 | $65 | $174 |
| Drug injection, under skin or into muscle A procedure involving the administration of a medication or substance via injection into the subcutaneous tissue or muscle. |
64 | $11 | $61 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
60 | $127 | $352 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
57 | $63 | $167 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
50 | $99 | $241 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
45 | $32 | $78 |
| Creatinine test (kidney function) A blood test that measures the amount of creatinine to assess kidney function or detect muscle injury. |
37 | $5 | $22 |
| Flu vaccine, quadrivalent A flu shot containing four strains of the influenza virus to help prevent seasonal influenza infection. |
37 | $76 | $183 |
| Electrocardiogram (EKG), 12-lead A standard heart rhythm test using at least 12 leads to record electrical activity. A healthcare provider interprets the results and provides a written report. |
37 | $10 | $62 |
| Hospital discharge management, 30+ min This service covers the care provided by a physician or qualified healthcare professional on the day a patient is discharged from the hospital. It requires more than 30 minutes of total time spent on the day of discharge. |
34 | $90 | $249 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
33 | $133 | $452 |
| Urine microalbumin test (kidney screening) A laboratory test that measures the amount of microalbumin, a small protein, in a urine sample. This test is used to detect early signs of kidney damage. |
32 | $6 | $52 |
| Drug test with direct observation A drug screening test performed under direct observation to ensure the sample is provided correctly. This method is used to verify the integrity of the specimen collection process. |
26 | $12 | $41 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
25 | $211 | $536 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
21 | $32 | $60 |
| Pneumococcal conjugate vaccine (PCV20) An intramuscular injection of the 20-valent pneumococcal conjugate vaccine. It is used to protect against diseases caused by Streptococcus pneumoniae bacteria. |
20 | $281 | $681 |
| Joint injection, major joint Removal of fluid from a large joint and/or injection of medication into the joint space. |
19 | $53 | $231 |
| Transitional care management services, moderate complexity Services provided to coordinate care during the transition from an inpatient or other facility setting back to the community. This includes follow-up and management of a health problem of at least moderate complexity. |
19 | $152 | $390 |
| Automated urinalysis An automated laboratory test performed on a urine sample to analyze its chemical and physical properties. The procedure uses machinery to detect various substances and cells within the urine. |
17 | $2 | $22 |
| Respiratory virus test for SARS-CoV-2, influenza A/B, and RSV A laboratory test that detects the presence of SARS-CoV-2 (COVID-19), influenza A, influenza B, and respiratory syncytial virus (RSV) in an upper respiratory specimen. |
16 | $140 | $313 |
| Initial preventive physical examination, new Medicare beneficiary A comprehensive preventive health visit for new Medicare beneficiaries during their first 12 months of enrollment. The service is conducted as a face-to-face visit and is limited to preventive care. |
13 | $172 | $378 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
12 | $10 | $30 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. These counts do not measure clinical quality or years of experience.
Industry Payment Transparency
Open Payments through 2024 ↗$2,575
Total received (2018-2024)
Avg $515/year across 5 years
Top 16% in IL for family medicine
A higher payment rank reflects disclosed industry relationships (consulting, research, speaking) common among subspecialists — not wrongdoing.
22
Companies
170
Payment records
Payments are publicly reported; disclosure does not establish legality · Not evidence of wrongdoing · How to interpret →
Payment categories are unavailable while the source breakdown is being rebuilt. Company and year totals do not identify how much belongs to each category.
Payment trend by year
Annual totals from pharmaceutical and medical device companies.
2024
$312
2023
$169
2022
$15
2019
$1,032
2018
$1,047
Payments by company (2024)
Lilly USA, LLC
$76
PFIZER INC.
$74
Novo Nordisk Inc
$50
GlaxoSmithKline, LLC.
$45
AstraZeneca Pharmaceuticals LP
$33
Janssen Pharmaceuticals, Inc
$17
Amgen Inc.
$16
Top 3 companies account for 64.0% of 2024 payments
All-time payments by company (2018-2024) ›
PFIZER INC.
$459
Novo Nordisk Inc
$312
GlaxoSmithKline, LLC.
$263
Allergan Inc.
$262
Amgen Inc.
$215
Lilly USA, LLC
$199
AstraZeneca Pharmaceuticals LP
$157
AbbVie, Inc.
$148
Boehringer Ingelheim Pharmaceuticals, Inc.
$97
Takeda Pharmaceuticals U.S.A., Inc.
$87
Genentech USA, Inc.
$57
Janssen Pharmaceuticals, Inc
$53
Merck Sharp & Dohme Corporation
$47
Shire North American Group Inc
$44
Salix Pharmaceuticals, a division of Bausch Health US, LLC
$37
ABBVIE INC.
$34
E.R. Squibb & Sons, L.L.C.
$23
Novartis Pharmaceuticals Corporation
$23
Amarin Pharma Inc.
$19
Teva Pharmaceuticals USA, Inc.
$15
Gilead Sciences, Inc.
$13
Horizon Pharma plc
$12
Top 3 companies account for 40.2% of all-time payments
Associated products mentioned in payments ›
ADVAIR · AJOVY · ANORO · AREXVY · BEXSERO · BREO · BYSTOLIC · CHANTIX · Creon · DUEXIS · ELIQUIS · EMGALITY · EVENITY · FARXIGA · INVOKANA · JANUVIA · LINZESS · LYRICA · MOUNJARO · MYDAYIS · Mavyret · Ozempic · PAXLOVID · PRADAXA · PREVNAR - 13 · PREVNAR 20 · Prolia · ROTATEQ · Repatha · Rybelsus · SHINGRIX · STIOLTO RESPIMAT · SYMBICORT · Saxenda · Synthroid · TRADJENTA · TRELEGY ELLIPTA · TRULICITY · Tresiba · Trintellix · VIIBRYD · VRAYLAR · VYVANSE · Vascepa · Victoza · Wegovy · XARELTO · XIFAXAN · XOLAIR · Xofluza
Should you be concerned? Industry payments are disclosed through CMS Open Payments. Disclosure alone does not establish their purpose, legality, or effect on care. What matters is whether a recommended drug or device appears in your doctor's payment records. If so, consider asking your doctor about it. How to interpret this data →
Geographic Context
Family medicine physicians in nearby ZIP areas
3,318
County median income
$81,797
Nearest hospital to ZIP centroid (approximate)
HINES VA MEDICAL CENTER
2.7 mi
2.7 mi
Data Sources
| Provider Registry | ✓ NPPES | NPPES snapshot; verify current record |
| Medicare Enrollment | ✓ PECOS | PECOS snapshot |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | ✓ Open Payments | CY 2024 |
| Disciplinary History | — Not included | N/A |
This provider has data in 4 of 4 available federal datasets, with a Data Coverage level of Very High. This reflects how much public data is available about a provider. How we calculate this →
Summary
Dr. Higgins is a clinical cardiology specialist, with above-average Medicare volume (top 4% in IL), with 20 years of NPI registration.
This summary is auto-generated from federal data, describing data availability and patterns. Read our methodology →
Frequently Asked Questions
Is Dr. Higgins experienced with denosumab injection (prolia/xgeva)?
Based on Medicare claims data, Dr. Higgins performed 1,320 denosumab injection (prolia/xgeva) services. These records cover Medicare fee-for-service activity, including eligible younger beneficiaries; they do not measure total practice volume or clinical quality.
Does Dr. Higgins receive payments from pharmaceutical companies?
Yes. Dr. Higgins received a total of $2,575 from 22 companies across 170 payment records. A record can group multiple payments. These transfers are publicly disclosed through CMS Open Payments. Disclosure alone does not establish their legality or effect on care. Patients may wish to ask their doctor about these relationships, especially if a recommended drug or device appears in the payment records.
How do Dr. Higgins's costs compare to other family medicine physicians in Westchester?
Dr. Higgins's average Medicare payment per service is $48. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently Very High for Dr. Higgins) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating the presence of registry, enrollment, activity or payment records, not verified experience or clinical quality. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Source publication dates and the snapshots loaded on this site can differ. Rebuilding a page does not refresh its source records. Check the Medicare reporting year and the payment interval shown above; consult the linked official sources for newer releases and current registry details. See our data freshness policy →
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About this page
This page combines public CMS records with calculated summaries and explanatory procedure labels. These transformations are not verbatim federal records. Sources: NPPES ↗, Open Payments ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. Data Coverage reflects data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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