Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1669485975 · CUBA, NM 87013 · Non-Pharmacy Dispensing Site · NPI assigned 08/15/2006

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

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

$4.02M
Total Medicaid Paid
38,684
Total Claims
34,725
Beneficiaries
71
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date08/15/2006

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 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 5,353 $523K
2019 5,126 $470K
2020 4,189 $437K
2021 8,080 $850K
2022 5,229 $573K
2023 6,538 $687K
2024 4,169 $484K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,621 8,362 $1.48M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 7,721 6,682 $1.12M
D0999 Unspecified diagnostic procedure, by report 2,591 2,307 $498K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 1,473 1,369 $242K
99441 437 404 $71K
0012A 418 399 $60K
0011A 385 370 $59K
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 1,964 1,431 $58K
91300 501 477 $50K
0001A 428 392 $42K
99442 235 213 $37K
0013A 220 213 $36K
D1206 Topical application of fluoride varnish 187 187 $31K
0072A 146 137 $25K
91301 429 425 $24K
0002A 259 249 $21K
0071A 116 110 $20K
D0120 Periodic oral evaluation - established patient 122 122 $19K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 109 108 $19K
D1120 Prophylaxis - child 108 106 $17K
H0049 Alcohol and/or drug screening 1,851 1,689 $13K
Q3014 Telehealth originating site facility fee 62 46 $11K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 53 51 $9K
0003A 58 58 $9K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 37 37 $7K
D0150 Comprehensive oral evaluation - new or established patient 55 55 $6K
36415 Collection of venous blood by venipuncture 1,837 1,763 $6K
99215 Prolong outpt/office vis 29 27 $5K
D0274 Bitewings - four radiographic images 39 39 $5K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 26 26 $4K
0064A 53 53 $4K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,171 1,163 $3K
D0272 Bitewings - two radiographic images 14 14 $2K
90834 Psychotherapy, 45 minutes with patient 13 13 $2K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 13 13 $2K
90460 Immunization administration through 18 years of age via any route, first or only component 163 157 $2K
83036 Hemoglobin; glycosylated (A1C) 845 800 $2K
87428 314 307 $2K
81002 660 630 $1K
D0230 Intraoral - periapical each additional radiographic image 22 15 $885.70
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 15 15 $840.64
90686 512 510 $801.32
90472 Immunization administration, each additional vaccine (list separately) 173 171 $387.58
91307 149 149 $359.24
84443 Thyroid stimulating hormone (TSH) 81 78 $356.76
36416 313 290 $193.69
H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood 1,057 913 $173.84
90656 12 12 $0.00
80053 Comprehensive metabolic panel 348 345 $0.00
96373 14 14 $0.00
82043 12 12 $0.00
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 33 33 $0.00
82607 22 22 $0.00
90688 102 102 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 130 129 $0.00
86803 12 12 $0.00
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe 30 28 $0.00
87086 Culture, bacterial; quantitative colony count, urine 27 27 $0.00
92551 20 20 $0.00
85018 12 12 $0.00
86703 13 13 $0.00
82570 12 12 $0.00
80061 Lipid panel 243 241 $0.00
99173 42 42 $0.00
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 372 367 $0.00
81025 59 55 $0.00
82274 15 15 $0.00
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe 30 28 $0.00
91320 12 12 $0.00
D0220 Intraoral - periapical first radiographic image 15 15 $0.00
90734 12 12 $0.00