Clinic
LA Familia Primary Care P C
LA Familia Primary Care P C was paid $1.73M by Medicaid between Jan 2018 and Nov 2024, across 76 billing codes. Its largest line is 99490, Ccm add 20min — 32% of everything it billed.
33Billing provider infoLA FAMILIA PRIMARY CARE P C
RATON, NM 87740
RATON, NM 87740
33aNPI1366525537assigned 10/23/2006
33bProvider typeClinic/Center
28Total paid$1.73M
24GClaims62,327
24DCodes billed76
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Clinic/Center providers in New Mexico
Rank by total paid#18 of 52
Median peer was paid$827K
This provider vs. median2.1×
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 | 10,231 | $289K | |
| 2019 | 11,573 | $281K | |
| 2020 | 9,910 | $253K | |
| 2021 | 11,059 | $347K | |
| 2022 | 8,230 | $178K | |
| 2023 | 5,868 | $190K | |
| 2024incomplete | 5,456 | $191K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99490 | Ccm add 20min | 32% | 22,079 | 21,638 | $552K |
| 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 | 27% | 7,901 | 7,149 | $460K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 20% | 7,695 | 6,776 | $349K |
| Q4206 | Fluid flow or fluid gf, 1 cc | 5.6% | 222 | 191 | $96K |
| G0481 | 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; 8-14 drug class(es), including metabolite(s) if performed | 3.5% | 1,357 | 1,174 | $60K |
| 80053 | Comprehensive metabolic panel | 1.4% | 1,666 | 1,620 | $24K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.1% | 739 | 686 | $19K |
| 80061 | Lipid panel | <1% | 1,419 | 1,381 | $16K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,437 | 1,403 | $12K |
| 99407 | <1% | 939 | 808 | $12K | |
| 90670 | <1% | 118 | 112 | $10K | |
| 99497 | <1% | 257 | 245 | $10K |
64 more codes
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,652 | $10K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 443 | $9K |
| G0396 | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes | <1% | 1,268 | $8K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 352 | $7K |
| 99402 | <1% | 260 | $6K | |
| 80305 | <1% | 764 | $6K | |
| 99454 | <1% | 1,678 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 1,944 | $5K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 47 | $5K |
| 99457 | <1% | 1,600 | $5K | |
| 90674 | <1% | 270 | $4K | |
| 99304 | <1% | 105 | $3K | |
| 90756 | <1% | 191 | $3K | |
| 96138 | <1% | 145 | $3K | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 240 | $2K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 164 | $2K |
| 96103 | <1% | 146 | $2K | |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 236 | $2K |
| 96127 | <1% | 457 | $2K | |
| 99408 | <1% | 139 | $2K | |
| 20611 | <1% | 189 | $2K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 13 | $2K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 426 | $2K |
| 99306 | Prolong nursin fac eval 15m | <1% | 27 | $1K |
| 99487 | Ccm add 20min | <1% | 24 | $1K |
| 0124A | <1% | 37 | $876.40 | |
| 93882 | <1% | 21 | $768.08 | |
| G0446 | Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes | <1% | 102 | $720.29 |
| 93978 | <1% | 15 | $710.26 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 38 | $688.90 |
| G0506 | Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) | <1% | 14 | $645.32 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 42 | $581.88 |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 259 | $478.50 |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 29 | $474.22 |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 27 | $471.77 |
| 0011A | <1% | 14 | $467.89 | |
| 0012A | <1% | 14 | $458.31 | |
| 0064A | <1% | 16 | $440.00 | |
| 0004A | <1% | 13 | $440.00 | |
| 99307 | <1% | 13 | $397.48 | |
| 90732 | <1% | 12 | $327.75 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 12 | $277.07 |
| 99401 | <1% | 12 | $263.41 | |
| 76775 | <1% | 16 | $211.14 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 16 | $210.17 |
| 92250 | <1% | 15 | $117.24 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 28 | $100.31 |
| 81003 | <1% | 57 | $96.62 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 28 | $91.37 |
| G0009 | Administration of pneumococcal vaccine | <1% | 67 | $50.34 |
| G0008 | Administration of influenza virus vaccine | <1% | 206 | $5.41 |
| 91312 | <1% | 26 | $0.08 | |
| 91313 | <1% | 12 | $0.02 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | <1% | 766 | $0.01 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | <1% | 706 | $0.01 |
| 3044F | 0% | 372 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 118 | $0.00 |
| G8432 | Depression screening not documented, reason not given | 0% | 45 | $0.00 |
| 90694 | 0% | 40 | $0.00 | |
| G8755 | Most recent diastolic blood pressure >= 90 mmhg | 0% | 39 | $0.00 |
| 91305 | 0% | 13 | $0.00 | |
| G8753 | Most recent systolic blood pressure >= 140 mmhg | 0% | 101 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 127 | $0.00 |
| 3046F | 0% | 230 | $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 officialZMILY, MISBAH (OWNERPRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Premier Family Medicine LLC | Denver, CO | $705K |
| Zmily Health Group INC. | Denver, CO | $340K |
| Zia Healthcare Services LLC | Raton, NM | $34K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.