SANTA CLARA HEALTH CENTER
NPI: 1043396377
· ESPANOLA, NM 87532
· General Acute Care Hospital
· NPI assigned 10/30/2006
$678K
Total Medicaid Paid
Provider Details
| Authorized Official | LYON, ROBERT (CHIEF EXECUTIVE OFFICER) |
| NPI Enumeration Date | 10/30/2006 |
Related Entities
Other providers sharing the same authorized official: LYON, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
221 |
$94K |
| 2019 |
114 |
$60K |
| 2020 |
335 |
$152K |
| 2021 |
342 |
$176K |
| 2022 |
99 |
$73K |
| 2023 |
163 |
$109K |
| 2024 |
16 |
$14K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q3014 |
Telehealth originating site facility fee |
725 |
508 |
$371K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
165 |
$113K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
180 |
172 |
$111K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
145 |
129 |
$62K |
| 0064A |
|
30 |
30 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
25 |
$217.80 |