Physician
The Pagosa Medical Group LLC
The Pagosa Medical Group LLC was paid $785K by Medicaid between Jan 2018 and Dec 2024, across 28 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 72% of everything it billed.
33Billing provider infoTHE PAGOSA MEDICAL GROUP LLC
PAGOSA SPGS, CO 81147
PAGOSA SPGS, CO 81147
33aNPI1255857660assigned 08/17/2017
33bProvider typeSurgery Physician
28Total paid$785K
24GClaims16,583
24DCodes billed28
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Surgery Physician providers in Colorado
Rank by total paid#6 of 78
Median peer was paid$10K
This provider vs. median79×
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.
Box 24A · Dates of service
Paid by month
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 661 | $34K | |
| 2019 | 2,417 | $101K | |
| 2020 | 2,428 | $72K | |
| 2021 | 2,822 | $124K | |
| 2022 | 2,246 | $132K | |
| 2023 | 3,225 | $176K | |
| 2024incomplete | 2,784 | $147K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 72% | 9,598 | 8,269 | $565K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 6.8% | 616 | 557 | $54K |
| 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 | 4.9% | 500 | 435 | $38K |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 3.2% | 535 | 501 | $25K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | 2.8% | 278 | 257 | $22K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | 2.7% | 629 | 602 | $21K |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 2.5% | 597 | 232 | $20K |
| 96366 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour | 1.2% | 570 | 219 | $10K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 513 | 506 | $7K |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 155 | 147 | $6K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 220 | 214 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 88 | 76 | $3K |
16 more codes
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 146 | $2K |
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | <1% | 33 | $2K |
| 93041 | <1% | 625 | $2K | |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | <1% | 505 | $2K |
| 0002A | <1% | 14 | $583.65 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 27 | $494.05 |
| 0031A | <1% | 12 | $340.68 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 28 | $309.25 |
| 94760 | <1% | 123 | $263.22 | |
| 99173 | <1% | 99 | $249.38 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 13 | $233.52 |
| 36415 | Collection of venous blood by venipuncture | <1% | 47 | $119.67 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | <1% | 547 | $73.56 |
| 81003 | <1% | 37 | $58.26 | |
| 90686 | <1% | 14 | $57.45 | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 14 | $25.46 |
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 officialGRIEGO, MICHELLE (COMMUNICATION DIRECTOR)