Supplier
Presbyterian Medical Services
Presbyterian Medical Services was paid $603K by Medicaid between Jan 2018 and Sep 2024, across 22 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 50% of everything it billed.
33Billing provider infoPRESBYTERIAN MEDICAL SERVICES
OJO ENCINO, NM 87013
OJO ENCINO, NM 87013
33aNPI1023186707assigned 12/01/2006
33bProvider typeNon-Pharmacy Dispensing Site
28Total paid$603K
24GClaims5,068
24DCodes billed22
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Non-Pharmacy Dispensing Site providers in New Mexico
Rank by total paid#16 of 19
Median peer was paid$1.05M
This provider vs. median0.6×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official SMITH, DOUG controls 20+ related entities in our dataset. Read more
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 | 433 | $58K | |
| 2019 | 344 | $44K | |
| 2020 | 379 | $53K | |
| 2021 | 959 | $108K | |
| 2022 | 1,014 | $131K | |
| 2023 | 1,332 | $138K | |
| 2024incomplete | 607 | $72K |
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 | 50% | 1,981 | 1,774 | $304K |
| 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 | 28% | 1,176 | 1,038 | $167K |
| 99441 | 10% | 381 | 357 | $62K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 7.4% | 293 | 259 | $45K |
| H0049 | Alcohol and/or drug screening | 1.0% | 556 | 520 | $6K |
| 0011A | <1% | 47 | 45 | $5K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 27 | 27 | $5K |
| 0012A | <1% | 45 | 41 | $4K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 17 | 17 | $3K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 35 | 26 | $1K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 17 | 17 | $550.17 |
| 87428 | <1% | 86 | 86 | $550.17 |
10 more codes
| 81002 | <1% | 14 | $388.78 | |
| 90686 | <1% | 75 | $179.62 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 30 | $0.00 |
| 80061 | Lipid panel | 0% | 12 | $0.00 |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 76 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 75 | $0.00 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 56 | $0.00 |
| H0048 | Alcohol and/or other drug testing: collection and handling only, specimens other than blood | 0% | 16 | $0.00 |
| 91301 | 0% | 41 | $0.00 | |
| 84443 | Thyroid stimulating hormone (TSH) | 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 officialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Presbyterian Medical Services | Farmington, NM | $41.17M |
| Presbyterian Medical Services | Santa Fe, NM | $16.45M |
| Presbyterian Medical Services | Santa Fe, NM | $13.33M |
| Presbyterian Medical Services | Grants, NM | $10.25M |
| Presbyterian Medical Services | Carlsbad, NM | $9.16M |
| Presbyterian Medical Services | Socorro, NM | $8.23M |
| Presbyterian Medical Services | Espanola, NM | $7.64M |
| PMS Dba Roundtree Childrens' Development Services | Farmington, NM | $6.89M |
| Presbyterian Medical Services | Rio Rancho, NM | $5.57M |
| Presbyterian Medical Services | Cuba, NM | $4.02M |
| Presbyterian Medical Services | Gallup, NM | $2.75M |
| Presbyterian Medical Services | Questa, NM | $2.53M |
| Presbyterian Medical Services | Santa Fe, NM | $2.04M |
| Presbyterian Medical Services | Farmington, NM | $1.61M |
| Presbyterian Medical Services | Tucumcari, NM | $1.43M |
| Presbyterian Medical Services | Mountainair, NM | $1.19M |
| Presbyterian Medical Services | Hobbs, NM | $1.10M |
| Presbyterian Medical Services | Torreon, NM | $1.05M |
| Presbyterian Medical Services | Tularosa, NM | $999K |
| Presbyterian Medical Services | Reserve, NM | $844K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.