Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Presbyterian Medical Services

Presbyterian Medical Services was paid $13.33M by Medicaid between Jan 2018 and Sep 2023, across 40 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 17% of everything it billed.

33Billing provider infoPRESBYTERIAN MEDICAL SERVICES
SANTA FE, NM 87505
33aNPI1124134028assigned 08/22/2006
28Total paid$13.33M
24GClaims96,965
24DCodes billed40
24AFirst – last monthJan 2018 – Sep 2023
Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in New Mexico

Rank by total paid#8 of 80
Median peer was paid$1.11M
This provider vs. median12×

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

$0$200K$400K2018201920202021202220232024
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
YearClaimsPaid
201826,405$3.37M
201915,729$1.83M
202011,676$1.58M
202114,072$2.15M
202217,740$2.73M
202311,343$1.65M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 17% 17,053 12,112 $2.33M
H0039 Assertive community treatment, face-to-face, per 15 minutes 15% 11,250 1,851 $1.95M
H2015 Community support for mental illness or disability, per 15 minutesComprehensive community support services, per 15 minutes 13% 9,830 2,930 $1.73M
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 12% 12,528 10,596 $1.65M
90853 Group psychotherapy (other than of a multiple-family group) 9.6% 7,611 3,641 $1.27M
90834 Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient 8.5% 6,744 3,880 $1.13M
90837 Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient 7.8% 6,293 3,337 $1.04M
99442 2.7% 2,169 1,684 $366K
90832 Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient 2.6% 2,063 1,392 $351K
90791 Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation 2.3% 1,861 1,839 $312K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1.7% 1,877 1,443 $229K
99441 1.5% 1,223 991 $205K
28 more codes
H2017 Psychosocial rehabilitation, billed per 15 minutes 1.1% 863 $144K
G0467 Community health center visit, returning patient <1% 5,512 $122K
Q3014 Telehealth originating site facility fee <1% 1,946 $111K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 2,398 $111K
99443 <1% 379 $62K
99215 Doctor's office visit, returning patient (complex) <1% 421 $58K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only <1% 1,526 $53K
90792 Psychiatric diagnostic evaluation with medical services <1% 171 $24K
H2011 Crisis intervention service, per 15 minutes <1% 142 $23K
0011A <1% 92 $15K
0012A <1% 61 $10K
H2033 Multisystemic therapy for juveniles, per 15 minutes <1% 49 $8K
36415 Collection of venous blood by venipuncture <1% 583 $5K
0013A <1% 34 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 153 $4K
H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood <1% 1,506 $3K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 16 $2K
0144A <1% 18 $2K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 70 $2K
83036 Hemoglobin; glycosylated (A1C) <1% 114 $1K
80305 <1% 34 $862.00
84443 Thyroid stimulating hormone (TSH) <1% 70 $683.31
90688 <1% 46 $504.82
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 44 $366.78
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 0% 34 $0.00
80306 0% 34 $0.00
80061 Lipid panel 0% 27 $0.00
80053 Comprehensive metabolic panel 0% 120 $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)
Same official

Other billing entities under SMITH, DOUG

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.