SKYLIGHT HEALTH GROUP CO LLC

NPI: 1376114769 · COLORADO SPRINGS, CO 80917 · Clinic/Center · NPI assigned 07/07/2021

$16K

Total Medicaid Paid

337

Total Claims

291

Beneficiaries

Codes Billed

2021-11

First Month

2022-06

Last Month

Provider Details

Authorized Official	GLUCHACKI, STEPHANIE (SVP COMPLIANCE)
NPI Enumeration Date	07/07/2021

Other providers sharing the same authorized official: GLUCHACKI, STEPHANIE

Provider	City	State	Total Paid
POTOMAC SQUARE FAMILY MEDICINE, LLC	AURORA	CO	$3.01M
ROCKY MOUNTAIN URGENT CARE, LLC	AURORA	CO	$2.77M
POTOMAC SQUARE FAMILY MEDICINE, LLC	WESTMINSTER	CO	$486K
POTOMAC SQUARE FAMILY MEDICINE, LLC	CENTENNIAL	CO	$191K
POTOMAC SQUARE FAMILY MEDICINE, LLC	BOULDER	CO	$63K

Year	Claims	Total Paid
2021	16	$922.92
2022	321	$15K

Code	Description	Claims	Beneficiaries	Total Paid
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	101	90	$6K
99204	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	41	41	$6K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	52	49	$4K
96127		34	20	$245.52
36415	Collection of venous blood by venipuncture	57	49	$150.68
99000		52	42	$9.30