Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SUMMIT PRIMARY CARE

NPI: 1316561558 · PUEBLO, CO 81004 · Family Medicine Physician · NPI assigned 06/03/2020

$1.81M
Total Medicaid Paid
66,466
Total Claims
58,884
Beneficiaries
65
Codes Billed
2020-09
First Month
2024-12
Last Month

Provider Details

Authorized OfficialDENNIS, NICOLE (VICE PRESIDENT)
NPI Enumeration Date06/03/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 9,336 $189K
2021 24,464 $567K
2022 12,949 $392K
2023 8,398 $259K
2024 11,319 $405K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 13,537 12,108 $889K
82075 14,576 13,055 $271K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,240 4,639 $203K
96127 17,378 15,212 $155K
90792 Psychiatric diagnostic evaluation with medical services 1,295 1,133 $132K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 3,014 2,492 $32K
96130 134 118 $8K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 311 294 $7K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 77 70 $6K
96136 373 334 $6K
99205 Prolong outpt/office vis 163 143 $5K
20553 108 83 $5K
99406 469 419 $4K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay 353 275 $3K
94010 97 90 $3K
83992 252 227 $2K
99401 93 88 $2K
G0483 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed 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 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 139 127 $2K
99497 123 112 $1K
90688 87 80 $827.52
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 50 48 $568.90
90686 47 42 $557.07
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 42 40 $544.77
36415 Collection of venous blood by venipuncture 218 194 $424.11
81025 34 31 $163.94
97802 47 45 $61.52
86328 79 59 $44.78
J1885 Injection, ketorolac tromethamine, per 15 mg 67 62 $41.20
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) 113 106 $2.81
J0592 Injection, buprenorphine hydrochloride, 0.1 mg 16 14 $0.00
J3490 Unclassified drugs 37 27 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 20 19 $0.00
99408 50 46 $0.00