SUMMIT PRIMARY CARE

$1.81M

Total Medicaid Paid

66,466

Total Claims

58,884

Beneficiaries

65

Codes Billed

2020-09

First Month

2024-12

Last Month

Code	Description	Claims	Beneficiaries	Total Paid
99214		13,537	12,108	$889K
82075		14,576	13,055	$271K
99213		5,240	4,639	$203K
96127		17,378	15,212	$155K
90792		1,295	1,133	$132K
G8510	Scr dep neg, no plan reqd	3,014	2,492	$32K
96130		134	118	$8K
99203		311	294	$7K
99204		77	70	$6K
96136		373	334	$6K
99205	Prolong outpt/office vis	163	143	$5K
20553		108	83	$5K
99406		469	419	$4K
80307		353	275	$3K
94010		97	90	$3K
83992		252	227	$2K
99401		93	88	$2K
G0483	Drug test def 22+ classes	12	12	$2K
80367		252	227	$2K
80350		252	227	$2K
80349		252	227	$2K
80368		252	227	$2K
80324		253	228	$2K
80371		252	227	$2K
80329		252	227	$2K
80335		252	227	$2K
80345		252	227	$2K
80353		252	227	$2K
80358		252	227	$2K
80359		252	227	$2K
80357		252	227	$2K
80365		252	227	$2K
80362		252	227	$2K
80342		252	227	$2K
80354		252	227	$2K
80369		252	227	$2K
80348		252	227	$2K
80356		252	227	$2K
80338		253	228	$2K
80361		252	227	$2K
80355		252	227	$2K
80372		252	227	$2K
80366		252	227	$2K
80346		252	227	$2K
80332		253	228	$2K
80360		252	227	$2K
80339		252	227	$2K
80373		252	227	$2K
80323		252	227	$2K
90471		139	127	$2K
99497		123	112	$1K
90688		87	80	$827.52
96372		50	48	$568.90
90686		47	42	$557.07
99202		42	40	$544.77
36415		218	194	$424.11
81025		34	31	$163.94
97802		47	45	$61.52
86328		79	59	$44.78
J1885	Ketorolac tromethamine inj	67	62	$41.20
G2211	Complex e/m visit add on	113	106	$2.81
J0592	Buprenorphine hydrochloride	16	14	$0.00
J3490	Drugs unclassified injection	37	27	$0.00
99396		20	19	$0.00
99408		50	46	$0.00

Medicaid Provider Spending