Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1205902376 · GRANTS, NM 87020 · Non-Pharmacy Dispensing Site · NPI assigned 11/28/2006

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

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

$10.25M
Total Medicaid Paid
93,780
Total Claims
75,787
Beneficiaries
80
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date11/28/2006

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 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
PRESBYTERIAN MEDICAL SERVICES THOREAU NM $675K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 12,781 $1.30M
2019 14,534 $1.32M
2020 15,694 $1.85M
2021 14,938 $1.84M
2022 13,345 $1.46M
2023 13,120 $1.41M
2024 9,368 $1.07M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 22,018 18,641 $3.20M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 14,568 12,690 $1.96M
H2015 Comprehensive community support services, per 15 minutes 8,206 2,848 $1.42M
90832 Psychotherapy, 30 minutes with patient 4,131 2,613 $716K
90837 Psychotherapy, 53 minutes with patient 3,189 2,093 $545K
90834 Psychotherapy, 45 minutes with patient 2,726 1,927 $473K
99441 2,671 2,304 $446K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2,018 1,609 $313K
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 6,037 4,483 $199K
99442 751 673 $125K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 630 625 $108K
90853 Group psychotherapy (other than of a multiple-family group) 621 260 $105K
90791 Psychiatric diagnostic evaluation 606 586 $101K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 409 401 $71K
Q3014 Telehealth originating site facility fee 1,547 994 $63K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 349 342 $60K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 257 245 $42K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 222 218 $33K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 528 398 $32K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 140 139 $21K
0011A 158 155 $19K
91300 124 107 $19K
99443 106 98 $18K
0012A 137 136 $17K
91301 108 106 $16K
99408 89 76 $16K
99215 Prolong outpt/office vis 99 89 $13K
0071A 94 91 $13K
0072A 81 78 $11K
H0050 Alcohol and/or drug services, brief intervention, per 15 minutes 69 64 $11K
0064A 75 74 $11K
90847 Family psychotherapy with the patient present, 50 minutes 55 39 $9K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 53 51 $8K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 41 41 $7K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 25 24 $4K
0144A 24 24 $4K
91307 27 25 $4K
0013A 21 19 $3K
0001A 80 75 $3K
36415 Collection of venous blood by venipuncture 3,785 3,599 $3K
90792 Psychiatric diagnostic evaluation with medical services 13 13 $2K
84443 Thyroid stimulating hormone (TSH) 1,431 1,424 $1K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 2,111 2,099 $1K
0002A 67 64 $1K
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 363 358 $938.95
90472 Immunization administration, each additional vaccine (list separately) 738 729 $737.61
83036 Hemoglobin; glycosylated (A1C) 2,249 2,234 $666.64
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 431 429 $470.96
85025 Blood count; complete (CBC), automated, and automated differential WBC count 1,389 1,383 $403.56
81002 706 652 $264.94
90460 Immunization administration through 18 years of age via any route, first or only component 246 235 $201.78
87428 603 593 $150.89
90688 335 334 $146.71
80053 Comprehensive metabolic panel 2,142 2,134 $56.24
G0008 Administration of influenza virus vaccine 51 50 $53.78
90686 1,026 1,022 $35.56
90715 143 142 $28.32
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) 34 34 $17.69
90670 99 99 $14.54
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 102 99 $9.59
86803 82 82 $0.00
87086 Culture, bacterial; quantitative colony count, urine 92 87 $0.00
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 194 185 $0.00
87522 Neg quan hep c or qual rna 12 12 $0.00
90651 80 80 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 15 15 $0.00
88142 48 40 $0.00
82607 24 24 $0.00
82043 58 58 $0.00
85027 41 41 $0.00
80061 Lipid panel 1,261 1,261 $0.00
86703 233 233 $0.00
82274 57 57 $0.00
81025 50 50 $0.00
83540 12 12 $0.00
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 187 185 $0.00
82570 59 58 $0.00
90734 49 49 $0.00
90633 44 44 $0.00
90461 28 27 $0.00