Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Physician

Southwest Pediatric and Family Care, LLC

Southwest Pediatric and Family Care, LLC was paid $7.51M by Medicaid between Jan 2018 and Dec 2024, across 102 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 24% of everything it billed.

33Billing provider infoSOUTHWEST PEDIATRIC AND FAMILY CARE, LLC
DEMING, NM 88030
33aNPI1881089886assigned 04/06/2015
33bProvider typePediatrics Physician
28Total paid$7.51M
24GClaims181,568
24DCodes billed102
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Pediatrics Physician providers in New Mexico

Rank by total paid#6 of 53
Median peer was paid$535K
This provider vs. median14×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$100K$200K$300K2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
201818,918$565K
201919,993$676K
202017,521$613K
202123,462$782K
202228,544$1.06M
202334,552$1.52M
2024incomplete38,578$2.29M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 24% 21,956 18,572 $1.82M
99214 Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 23% 17,077 14,341 $1.76M
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 4.8% 3,242 3,185 $359K
90460 Immunization administration through 18 years of age via any route, first or only component 4.6% 6,781 6,728 $349K
99442 4.5% 3,205 2,913 $340K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 3.7% 2,622 2,423 $274K
90461 3.3% 3,739 3,721 $247K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 3.2% 5,740 4,517 $243K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 3.2% 2,314 2,307 $239K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 2.8% 5,610 5,515 $213K
99215 Doctor's office visit, returning patient (complex)Prolong outpt/office vis 2.0% 828 755 $152K
99177 1.9% 4,894 4,877 $141K
90 more codes
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 1.7% 1,238 $128K
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 1.5% 2,428 $110K
87634 1.1% 1,202 $84K
96110 Developmental screening, with scoring and documentation, per standardized instrument 1.1% 5,994 $82K
99173 <1% 2,606 $72K
88738 <1% 13,101 $66K
99203 Doctor's office visit, new patient (routine) <1% 584 $61K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 1,105 $58K
99422 <1% 763 $46K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 418 $42K
90791 Psychiatric diagnostic evaluation <1% 153 $40K
83655 <1% 2,924 $39K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 1,995 $38K
Q3014 Telehealth originating site facility fee <1% 1,336 $38K
90837 Psychotherapy session, about an hour <1% 226 $36K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 1,305 $30K
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 1,896 $30K
86328 <1% 628 $29K
99204 Doctor's office visit, new patient (more involved) <1% 195 $29K
82962 <1% 8,113 $28K
85018 <1% 9,047 $23K
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 738 $22K
80305 <1% 1,303 $17K
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 681 $16K
92551 <1% 1,410 $16K
S9999 Sales tax <1% 1,631 $15K
87631 <1% 82 $14K
99050 <1% 1,226 $14K
81003 <1% 6,628 $13K
90686 <1% 1,837 $13K
99443 <1% 92 $12K
99080 <1% 1,770 $12K
95004 Percutaneous tests with allergenic extracts, immediate type reaction <1% 55 $10K
36415 Collection of venous blood by venipuncture <1% 2,572 $10K
83036 Hemoglobin; glycosylated (A1C) <1% 977 $10K
86769 <1% 209 $9K
99205 Prolong outpt/office vis <1% 41 $9K
99441 <1% 176 $9K
80061 Lipid panel <1% 635 $8K
90834 Psychotherapy session, about 45 minutes <1% 44 $4K
87807 <1% 291 $4K
95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials <1% 15 $4K
H0033 Oral medication administration, direct observation <1% 101 $3K
99382 <1% 14 $2K
99381 <1% 13 $2K
99072 <1% 4,516 $2K
90670 <1% 1,120 $1K
81001 <1% 389 $1K
94760 <1% 3,772 $1K
90473 <1% 64 $929.49
92552 <1% 49 $838.25
92567 <1% 38 $534.66
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 350 $502.89
36416 <1% 2,234 $460.66
90651 <1% 290 $383.10
90656 <1% 74 $324.40
99188 <1% 41 $320.00
90734 <1% 134 $275.28
90681 <1% 380 $266.66
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 25 $259.45
90688 <1% 14 $210.00
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 327 $163.52
90647 <1% 1,110 $135.27
81025 <1% 14 $118.39
A7003 Administration set, with small volume nonfiltered pneumatic nebulizer, disposable <1% 60 $86.51
90723 <1% 454 $63.72
J0290 Injection, ampicillin sodium, 500 mg <1% 31 $62.56
90633 <1% 603 $37.17
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 12 $1.05
G8754 Most recent diastolic blood pressure < 90 mmhg 0% 1,089 $0.00
3044F 0% 723 $0.00
90677 0% 399 $0.00
1036F 0% 1,516 $0.00
A9150 Non-prescription drugs 0% 51 $0.00
90696 0% 30 $0.00
S9445 Patient education, not otherwise classified, non-physician provider, individual, per session 0% 95 $0.00
90698 0% 34 $0.00
90620 0% 37 $0.00
E0570 Nebulizer, with compressor 0% 14 $0.00
90716 0% 24 $0.00
G8752 Most recent systolic blood pressure < 140 mmhg 0% 1,097 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 0% 1,604 $0.00
90710 0% 330 $0.00
90671 0% 203 $0.00
G8417 Bmi is documented above normal parameters and a follow-up plan is documented 0% 253 $0.00
G8483 Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) 0% 108 $0.00
D0415 0% 18 $0.00
90715 0% 12 $0.00
90707 0% 12 $0.00
G8484 Influenza immunization was not administered, reason not given 0% 12 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialROQUE, JOEL (COO / CO-OWNER)