Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1396824223 · COUNSELOR, NM 87018 · Non-Pharmacy Dispensing Site · NPI assigned 11/02/2006

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

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

$251K
Total Medicaid Paid
1,858
Total Claims
1,693
Beneficiaries
18
Codes Billed
2018-01
First Month
2024-09
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date11/02/2006

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 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

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 298 $38K
2019 134 $18K
2020 772 $107K
2021 413 $58K
2022 113 $15K
2023 67 $10K
2024 61 $7K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 861 777 $125K
99441 308 286 $48K
99442 166 159 $26K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 177 155 $22K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 56 52 $7K
0012A 28 28 $5K
0011A 26 25 $5K
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 46 36 $4K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 21 17 $3K
Q3014 Telehealth originating site facility fee 19 18 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 12 12 $2K
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 20 15 $790.20
90686 46 45 $7.36
81002 12 12 $0.00
36416 18 14 $0.00
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 15 15 $0.00
H0049 Alcohol and/or drug screening 15 15 $0.00
82962 12 12 $0.00