MESCALERO INDIAN HOSPITAL
NPI: 1891886065
· MESCALERO, NM 88340
· Rural Acute Care Hospital
· NPI assigned 09/27/2006
$1.94M
Total Medicaid Paid
Provider Details
| Authorized Official | SIMMONS, DORLYNN (CHIEF EXECUTIVE OFFICER) |
| NPI Enumeration Date | 09/27/2006 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
86 |
$3K |
| 2020 |
1,252 |
$518K |
| 2021 |
2,414 |
$1.09M |
| 2022 |
463 |
$266K |
| 2023 |
108 |
$69K |
| 2024 |
27 |
$868.94 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q3014 |
Telehealth originating site facility fee |
1,982 |
1,673 |
$970K |
| 0001A |
|
426 |
425 |
$218K |
| 0011A |
|
412 |
412 |
$211K |
| 0064A |
|
273 |
270 |
$145K |
| 0071A |
|
189 |
189 |
$100K |
| 0072A |
|
176 |
175 |
$95K |
| 0004A |
|
82 |
82 |
$42K |
| 0002A |
|
63 |
63 |
$33K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
411 |
286 |
$29K |
| 0054A |
|
39 |
38 |
$24K |
| 0134A |
|
31 |
31 |
$20K |
| 99441 |
|
106 |
86 |
$20K |
| 0012A |
|
32 |
32 |
$17K |
| 0031A |
|
19 |
19 |
$10K |
| 0124A |
|
14 |
14 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
78 |
$808.55 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$592.47 |