Medicaid Provider Spending

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

PUEBLO OF JEMEZ

NPI: 1225346547 · JEMEZ PUEBLO, NM 87024 · Clinic/Center · NPI assigned 09/21/2010

$272K
Total Medicaid Paid
6,436
Total Claims
4,807
Beneficiaries
10
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialROSALES, NOHEMY (BUSINESS OFFICE MANAGER)
NPI Enumeration Date09/21/2010

Related Entities

Other providers sharing the same authorized official: ROSALES, NOHEMY

ProviderCityStateTotal Paid
PUEBLO OF JEMEZ JEMEZ PUEBLO NM $1.95M
PUEBLO OF JEMEZ JEMEZ PUEBLO NM $140K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,664 $60K
2019 1,456 $50K
2020 809 $29K
2021 649 $25K
2022 675 $45K
2023 686 $41K
2024 497 $23K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
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 3,942 2,787 $244K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 1,558 1,238 $12K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 164 122 $8K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 497 431 $6K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 190 144 $1K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient 13 13 $78.80
36415 Collection of venous blood by venipuncture 25 25 $41.52
G0008 Administration of influenza virus vaccine 20 20 $19.93
36416 13 13 $0.00
90653 14 14 $0.00