Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRESBYTERIAN MEDICAL SERVICES

NPI: 1023186707 · OJO ENCINO, NM 87013 · Non-Pharmacy Dispensing Site · NPI assigned 12/01/2006

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official SMITH, DOUG controls 20+ related entities in our dataset. Read more

$603K
Total Medicaid Paid
5,068
Total Claims
4,607
Beneficiaries
22
Codes Billed
2018-01
First Month
2024-09
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date12/01/2006

Related Entities

Other providers sharing the same authorized official: SMITH, DOUG

ProviderCityStateTotal 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 433 $58K
2019 344 $44K
2020 379 $53K
2021 959 $108K
2022 1,014 $131K
2023 1,332 $138K
2024 607 $72K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,981 1,774 $304K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,176 1,038 $167K
99441 381 357 $62K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 293 259 $45K
H0049 Alcohol and/or drug screening 556 520 $6K
0011A 47 45 $5K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 27 27 $5K
0012A 45 41 $4K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 17 17 $3K
G0467 Federally 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 35 26 $1K
90460 Immunization administration through 18 years of age via any route, first or only component 17 17 $550.17
87428 86 86 $550.17
81002 14 14 $388.78
90686 75 75 $179.62
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 30 29 $0.00
80061 Lipid panel 12 12 $0.00
83036 Hemoglobin; glycosylated (A1C) 76 75 $0.00
36415 Collection of venous blood by venipuncture 75 70 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 56 56 $0.00
H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood 16 16 $0.00
91301 41 41 $0.00
84443 Thyroid stimulating hormone (TSH) 12 12 $0.00