Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1285646455 · FARMINGTON, NM 87401 · Federally Qualified Health Center (FQHC) · NPI assigned 08/13/2006

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

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

$41.17M
Total Medicaid Paid
298,485
Total Claims
205,793
Beneficiaries
98
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date08/13/2006

Related Entities

Other providers sharing the same authorized official: SMITH, DOUG

ProviderCityStateTotal Paid
PRESBYTERIAN MEDICAL SERVICES SANTA FE NM $16.45M
PRESBYTERIAN MEDICAL SERVICES SANTA FE NM $13.33M
PRESBYTERIAN MEDICAL SERVICES GRANTS NM $10.25M
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 47,056 $5.21M
2019 39,120 $4.39M
2020 41,524 $5.76M
2021 47,084 $6.99M
2022 48,799 $7.19M
2023 43,479 $6.55M
2024 31,423 $5.10M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90853 Group psychotherapy (other than of a multiple-family group) 45,586 8,777 $7.92M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 50,774 44,413 $7.43M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 40,933 36,484 $6.02M
H2015 Comprehensive community support services, per 15 minutes 26,392 11,143 $4.51M
D0999 Unspecified diagnostic procedure, by report 14,083 12,129 $2.76M
H2017 Psychosocial rehabilitation services, per 15 minutes 13,879 1,867 $2.44M
90834 Psychotherapy, 45 minutes with patient 11,880 8,118 $2.08M
90832 Psychotherapy, 30 minutes with patient 9,160 6,066 $1.56M
90837 Psychotherapy, 53 minutes with patient 7,635 5,444 $1.32M
90791 Psychiatric diagnostic evaluation 4,627 4,508 $787K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,312 4,091 $687K
99442 2,499 2,334 $409K
99441 2,501 2,305 $398K
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 12,972 9,904 $376K
Q3014 Telehealth originating site facility fee 5,037 3,751 $323K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,974 1,939 $310K
90792 Psychiatric diagnostic evaluation with medical services 1,446 1,381 $238K
99443 1,152 1,084 $192K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 954 910 $154K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 929 917 $145K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 839 823 $127K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 665 653 $104K
0011A 591 572 $94K
99215 Prolong outpt/office vis 455 433 $76K
0012A 446 431 $73K
90460 Immunization administration through 18 years of age via any route, first or only component 2,054 1,858 $64K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 349 343 $59K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 1,063 898 $53K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 315 313 $52K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 384 381 $50K
H2033 Multisystemic therapy for juveniles, per 15 minutes 270 39 $42K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 3,033 3,004 $35K
96110 Developmental screening, with scoring and documentation, per standardized instrument 877 857 $28K
83036 Hemoglobin; glycosylated (A1C) 3,524 3,508 $25K
91300 180 170 $24K
0001A 231 215 $23K
D9995 190 176 $17K
0072A 105 98 $14K
0071A 114 107 $14K
90686 2,775 2,767 $12K
D0140 Limited oral evaluation - problem focused 221 216 $11K
G0511 Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month 121 88 $11K
0013A 76 72 $10K
91307 56 55 $10K
87428 621 608 $9K
91301 132 128 $7K
0002A 100 93 $6K
36415 Collection of venous blood by venipuncture 2,413 2,364 $5K
H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood 3,278 2,984 $5K
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 576 574 $5K
D0190 100 100 $4K
81002 899 879 $4K
0031A 29 27 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,569 1,410 $3K
90734 489 487 $3K
90715 1,038 1,033 $3K
90651 653 652 $2K
99201 12 12 $2K
90472 Immunization administration, each additional vaccine (list separately) 287 281 $1K
90677 14 14 $1K
D0150 Comprehensive oral evaluation - new or established patient 257 251 $1K
88142 169 147 $843.70
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 329 326 $840.40
90461 1,130 1,121 $558.54
90633 57 57 $538.86
36416 3,265 3,244 $522.37
92250 225 225 $424.82
81025 112 110 $356.76
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 71 71 $183.39
90696 23 23 $179.62
90670 55 55 $177.14
G0008 Administration of influenza virus vaccine 198 197 $99.34
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) 96 95 $28.68
J1050 Injection, medroxyprogesterone acetate, 1 mg 81 81 $9.27
90688 454 447 $5.72
90732 111 111 $5.18
82570 59 57 $0.00
90710 25 25 $0.00
J1631 Injection, haloperidol decanoate, per 50 mg 31 24 $0.00
84439 42 42 $0.00
80061 Lipid panel 250 248 $0.00
D0330 Panoramic radiographic image 12 12 $0.00
D1110 Prophylaxis - adult 69 67 $0.00
84443 Thyroid stimulating hormone (TSH) 218 209 $0.00
80053 Comprehensive metabolic panel 299 297 $0.00
81001 31 31 $0.00
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 331 326 $0.00
82043 58 57 $0.00
87086 Culture, bacterial; quantitative colony count, urine 37 36 $0.00
85027 67 67 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 41 39 $0.00
82728 12 12 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 218 218 $0.00
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 30 29 $0.00
91305 16 15 $0.00
D1208 Topical application of fluoride, excluding varnish 13 13 $0.00
90656 12 12 $0.00
H0049 Alcohol and/or drug screening 112 108 $0.00