Medicaid Provider Spending

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

PRESBYTERIAN MEDICAL SERVICES

NPI: 1851741359 · SANTA FE, NM 87507 · Federally Qualified Health Center (FQHC) · NPI assigned 06/15/2016

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

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

$16.45M
Total Medicaid Paid
103,639
Total Claims
64,287
Beneficiaries
47
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSMITH, DOUG (EXECUTIVE VICE PRESIDENT)
NPI Enumeration Date06/15/2016

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 $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
PRESBYTERIAN MEDICAL SERVICES THOREAU NM $675K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 17,038 $2.65M
2019 13,516 $1.92M
2020 12,892 $2.01M
2021 12,211 $2.02M
2022 13,867 $2.33M
2023 15,257 $2.56M
2024 18,858 $2.96M

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
90832 Psychotherapy, 30 minutes with patient 20,562 10,821 $3.60M
90834 Psychotherapy, 45 minutes with patient 17,295 9,535 $3.07M
H2015 Comprehensive community support services, per 15 minutes 12,581 3,666 $2.21M
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 14,327 12,218 $2.18M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9,297 8,091 $1.40M
90837 Psychotherapy, 53 minutes with patient 5,203 3,338 $929K
90791 Psychiatric diagnostic evaluation 4,379 4,340 $768K
90847 Family psychotherapy with the patient present, 50 minutes 3,758 2,087 $676K
H0039 Assertive community treatment, face-to-face, per 15 minutes 1,482 172 $297K
Q3014 Telehealth originating site facility fee 3,422 2,070 $241K
90846 Family psychotherapy without the patient present, 50 minutes 1,152 688 $201K
T1005 Respite care services, up to 15 minutes 1,093 223 $161K
90853 Group psychotherapy (other than of a multiple-family group) 922 427 $159K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 864 804 $137K
90792 Psychiatric diagnostic evaluation with medical services 554 543 $100K
H2033 Multisystemic therapy for juveniles, per 15 minutes 352 50 $56K
99441 285 266 $48K
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 2,205 1,645 $43K
99442 210 203 $35K
0071A 109 108 $19K
0011A 113 111 $18K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 98 97 $18K
G2025 Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only 610 357 $17K
0072A 77 76 $13K
0012A 56 56 $10K
G0480 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; 1-7 drug class(es), including metabolite(s) if performed 772 656 $9K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 43 43 $8K
D0999 Unspecified diagnostic procedure, by report 30 27 $7K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 30 29 $5K
0001A 38 38 $5K
0013A 17 17 $3K
G0071 Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only 185 134 $3K
91300 15 15 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 14 14 $2K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 130 115 $2K
99173 31 31 $1K
90460 Immunization administration through 18 years of age via any route, first or only component 114 109 $925.08
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 132 129 $845.30
36415 Collection of venous blood by venipuncture 12 12 $718.48
85025 Blood count; complete (CBC), automated, and automated differential WBC count 125 123 $354.28
80061 Lipid panel 12 12 $177.14
G0470 Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health 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 mental health visit 24 12 $136.39
80053 Comprehensive metabolic panel 160 158 $0.00
90686 86 86 $0.00
83036 Hemoglobin; glycosylated (A1C) 54 54 $0.00
H0048 Alcohol and/or other drug testing: collection and handling only, specimens other than blood 517 389 $0.00
90688 92 92 $0.00