Is NEW MEXICO DEPARTMENT OF HEALTH flagged for Medicaid fraud?

NEW MEXICO DEPARTMENT OF HEALTH (NPI: 1194886499) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does NEW MEXICO DEPARTMENT OF HEALTH bill Medicaid?

NEW MEXICO DEPARTMENT OF HEALTH received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Durable Medical Equipment & Medical Supplies, Customized Equipment provider. Located in ALBUQUERQUE, NM.

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NEW MEXICO DEPARTMENT OF HEALTH

Durable Medical Equipment & Medical Supplies, Customized Equipment·ALBUQUERQUE, NM·NPI: 1194886499Share

Active Billing Period:2018-01→2024-11(82 months)

Total Paid

$60.4M

$60,363,739

Total Claims

186K

Beneficiaries

13K

14.7 claims/patient

Avg Cost/Claim

$324

Monthly Spending Trend

Yearly Spending

2018

$7.4M

+1%

2019

$7.5M

+9%

2020

$8.1M

+22%

2021

$9.9M

+11%

2022

$11.0M

+1%

2023

$11.0M

-51%

2024

$5.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 5 distinct procedure codes. The top code (T2016 (Habilitation, residential, waiver; per diem)) accounts for 78% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T2016Habilitation, residential, waiver; per diemSee all providers →

$47.3M

116K claims

$406.74

$331.94

1.2×

Normal range

T2016Normal range

Habilitation, residential, waiver; per diem

$47.3M

116K claims · 78.4%

Your Cost: $406.74/claim|Median: $331.94

1.2× median

H2021Community-based wrap-around services, per 15 minSee all providers →

$5.3M

32K claims

$165.78

$169.11

1.0×

Normal range

H2021Normal range

Community-based wrap-around services, per 15 min

$5.3M

32K claims · 8.8%

Your Cost: $165.78/claim|Median: $169.11

1.0× median

T2021Day habilitation, waiver; per 15 minSee all providers →

$3.2M

32K claims

$98.83

$150.51

0.7×

Normal range

T2021Normal range

Day habilitation, waiver; per 15 min

$3.2M

32K claims · 5.2%

Your Cost: $98.83/claim|Median: $150.51

0.7× median

T2033Residential care, NOS; per diemSee all providers →

$3.0M

3,987 claims

$748.48

$1,051.57

0.7×

Normal range

T2033Normal range

Residential care, NOS; per diem

$3.0M

3,987 claims · 4.9%

Your Cost: $748.48/claim|Median: $1,051.57

0.7× median

T2025Waiver services, NOS; per 15 minSee all providers →

$1.6M

1,582 claims

$984.34

$124.39

7.9×

Top 5%

T2025Top 5%

Waiver services, NOS; per 15 min

$1.6M

1,582 claims · 2.6%

Your Cost: $984.34/claim|Median: $124.39

7.9× median

Other Top Providers in New Mexico

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Ambercare Home Health Care Corporation

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Unm Hospital

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$463.3M

Presbyterian Healthcare Services

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$345.5M

Presbyterian Healthcare Services

Surgery

$240.2M

DHHS PHS Naihs Shiprock Hospital

General Acute Care Hospital

$190.6M

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