SAN FELIPE HEALTH CLINIC
NPI: 1831274851
· SAN FELIPE, NM 87001
· General Acute Care Hospital
· NPI assigned 10/26/2006
$896K
Total Medicaid Paid
Provider Details
| Authorized Official | LYON, ROBERT (CHIEF EXECUTIVE OFFICER) |
| Parent Organization | SANTA FE INDIAN HOSPITAL |
| NPI Enumeration Date | 10/26/2006 |
Related Entities
Other providers sharing the same authorized official: LYON, ROBERT
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,025 |
$276K |
| 2019 |
779 |
$137K |
| 2020 |
380 |
$155K |
| 2021 |
287 |
$141K |
| 2022 |
278 |
$160K |
| 2023 |
54 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,670 |
1,329 |
$810K |
| Q3014 |
Telehealth originating site facility fee |
97 |
73 |
$46K |
| 0012A |
|
19 |
19 |
$10K |
| 0001A |
|
16 |
16 |
$8K |
| 0011A |
|
16 |
16 |
$8K |
| 0002A |
|
12 |
12 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
827 |
721 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
146 |
136 |
$1K |