Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1427124601 · TULAROSA, NM 88352 · Non-Pharmacy Dispensing Site · NPI assigned 11/28/2006

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

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

$999K
Total Medicaid Paid
7,924
Total Claims
6,936
Beneficiaries
23
Codes Billed
2018-01
First Month
2024-10
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date11/28/2006

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 RESERVE NM $844K
PRESBYTERIAN MEDICAL SERVICES THOREAU NM $675K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,658 $167K
2019 1,337 $160K
2020 1,066 $143K
2021 917 $120K
2022 1,109 $155K
2023 995 $141K
2024 842 $113K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 4,186 3,590 $614K
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 1,655 1,484 $223K
99441 528 503 $89K
99442 154 146 $26K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 171 162 $24K
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 611 444 $15K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 13 13 $2K
0011A 12 12 $2K
80053 Comprehensive metabolic panel 16 16 $605.34
83036 Hemoglobin; glycosylated (A1C) 106 104 $556.06
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 62 58 $363.01
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 98 98 $195.02
87428 62 59 $183.39
36415 Collection of venous blood by venipuncture 29 27 $164.34
90715 12 12 $9.28
90688 48 48 $8.94
90686 24 23 $0.00
36416 49 49 $0.00
86803 12 12 $0.00
84443 Thyroid stimulating hormone (TSH) 24 24 $0.00
80061 Lipid panel 15 15 $0.00
84439 24 24 $0.00
99173 13 13 $0.00