Dental
Summit Smiles PLLC
Summit Smiles PLLC was paid $179K by Medicaid between Jul 2022 and Jul 2024, across 13 billing codes. Its largest line is D1110, Prophylaxis - adult — 22% of everything it billed.
33Billing provider infoSUMMIT SMILES PLLC
FEDERAL HEIGHTS, CO 80260
FEDERAL HEIGHTS, CO 80260
33aNPI1487312039assigned 12/01/2021
33bProvider typeGeneral Practice Dentistry
28Total paid$179K
24GClaims5,587
24DCodes billed13
24AFirst – last monthJul 2022 – Jul 2024
Compared with peers
Next to other General Practice Dentistry providers in Colorado
Rank by total paid#179 of 521
Median peer was paid$53K
This provider vs. median3.4×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2022 | 1,819 | $61K | |
| 2023 | 2,328 | $75K | |
| 2024incomplete | 1,440 | $43K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 22% | 899 | 897 | $39K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 13% | 173 | 94 | $23K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 12% | 946 | 945 | $22K |
| D0150 | Comprehensive oral evaluation - new or established patient | 9.8% | 448 | 446 | $18K |
| D0220 | Intraoral - periapical first radiographic image | 8.9% | 1,252 | 1,237 | $16K |
| D0274 | Bitewings - four radiographic images | 8.7% | 516 | 516 | $16K |
| D0140 | Limited oral evaluation - problem focused | 8.4% | 437 | 432 | $15K |
| D0210 | Intraoral - complete series of radiographic images | 7.1% | 207 | 206 | $13K |
| D0230 | Intraoral - periapical each additional radiographic image | 4.6% | 609 | 608 | $8K |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 2.2% | 39 | 24 | $4K |
| D2393 | Resin-based composite - three surfaces, posterior, primary or permanent | 2.1% | 24 | 15 | $4K |
| D4910 | <1% | 25 | 25 | $2K |
1 more codes
| D1206 | Topical application of fluoride varnish | <1% | 12 | $205.56 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialLYDIATT, JOHN (OWNER)
| Provider | Location | Paid |
|---|---|---|
| Summit Smiles PLLC | Centennial, CO | $525K |
| Advanced Dental Center, PLLC | Federal Heights, CO | $50K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.