SUMMIT COMMUNITY CARE CLINIC, INC.
NPI: 1437533031
· LEADVILLE, CO 80461
· Federally Qualified Health Center (FQHC)
· NPI assigned 07/13/2015
$100K
Total Medicaid Paid
Provider Details
| Authorized Official | COGDILL, JOSH (CEO) |
| NPI Enumeration Date | 07/13/2015 |
Related Entities
Other providers sharing the same authorized official: COGDILL, JOSH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
97 |
$12K |
| 2020 |
30 |
$5K |
| 2021 |
262 |
$45K |
| 2022 |
197 |
$33K |
| 2023 |
15 |
$4K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| D0999 |
Unspecified diagnostic procedure, by report |
329 |
291 |
$97K |
| D1206 |
Topical application of fluoride varnish |
149 |
142 |
$1K |
| D1110 |
Prophylaxis - adult |
52 |
49 |
$909.00 |
| D1120 |
Prophylaxis - child |
24 |
24 |
$225.00 |
| D0190 |
|
47 |
46 |
$80.00 |