DHHS, PHS, NAIHS, GALLUP INDIAN MEDICAL CENTER
NPI: 1902875594
· TOHATCHI, NM 87325
· Federal Public Health Clinic/Center
· NPI assigned 03/16/2006
$2.46M
Total Medicaid Paid
Provider Details
Related Entities
Other providers sharing the same authorized official: DETSOI-SMILEY, PAMELA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,093 |
$93K |
| 2019 |
781 |
$79K |
| 2020 |
2,448 |
$953K |
| 2021 |
2,274 |
$894K |
| 2022 |
1,108 |
$267K |
| 2023 |
776 |
$98K |
| 2024 |
660 |
$80K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q3014 |
Telehealth originating site facility fee |
2,795 |
2,352 |
$1.31M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,734 |
3,725 |
$486K |
| 0011A |
|
330 |
329 |
$169K |
| 0012A |
|
315 |
314 |
$162K |
| 0064A |
|
158 |
158 |
$83K |
| 0072A |
|
65 |
65 |
$38K |
| 0124A |
|
69 |
68 |
$37K |
| 0002A |
|
64 |
64 |
$32K |
| 0071A |
|
57 |
57 |
$32K |
| 0134A |
|
69 |
67 |
$25K |
| 0001A |
|
49 |
49 |
$24K |
| 0004A |
|
41 |
41 |
$21K |
| 0054A |
|
23 |
23 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
20 |
16 |
$13K |
| 0003A |
|
22 |
22 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
38 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56 |
51 |
$587.25 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
35 |
33 |
$572.39 |
| G0008 |
Administration of influenza virus vaccine |
97 |
95 |
$152.93 |
| 90694 |
|
34 |
32 |
$40.32 |
| 90688 |
|
32 |
32 |
$24.71 |
| 90686 |
|
15 |
15 |
$0.00 |
| 90662 |
|
12 |
12 |
$0.00 |