SUMMIT COMMUNITY CARE CLINIC
NPI: 1801181169
· FRISCO, CO 80443
· Dental Clinic/Center
· NPI assigned 06/15/2011
$251K
Total Medicaid Paid
Provider Details
| Authorized Official | COGDILL, JOSH (CEO) |
| NPI Enumeration Date | 06/15/2011 |
Related Entities
Other providers sharing the same authorized official: COGDILL, JOSH
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
837 |
$251K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
633 |
575 |
$251K |
| D0190 |
|
32 |
32 |
$0.00 |
| D1110 |
Prophylaxis - adult |
48 |
48 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
94 |
94 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
13 |
13 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
17 |
17 |
$0.00 |