Physician
Summit Medical Clinic, PC
Summit Medical Clinic, PC was paid $2.93M by Medicaid between Jan 2018 and Dec 2024, across 79 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 46% of everything it billed.
33Billing provider infoSUMMIT MEDICAL CLINIC, PC
COLORADO SPRINGS, CO 80907
COLORADO SPRINGS, CO 80907
33aNPI1992709653assigned 06/10/2005
33bProvider typeInternal Medicine Physician
28Total paid$2.93M
24GClaims134,006
24DCodes billed79
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Internal Medicine Physician providers in Colorado
Rank by total paid#12 of 193
Median peer was paid$34K
This provider vs. median86×
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 | |
|---|---|---|---|
| 2018 | 15,075 | $447K | |
| 2019 | 15,626 | $444K | |
| 2020 | 17,373 | $455K | |
| 2021 | 21,002 | $457K | |
| 2022 | 18,530 | $437K | |
| 2023 | 30,017 | $412K | |
| 2024incomplete | 16,383 | $277K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 46% | 27,989 | 17,219 | $1.35M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 29% | 20,654 | 15,315 | $844K |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 4.6% | 41,149 | 26,056 | $133K |
| 99406 | 2.8% | 11,602 | 7,281 | $83K | |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 2.3% | 2,401 | 1,034 | $68K |
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 2.0% | 1,495 | 1,074 | $57K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.9% | 1,062 | 711 | $57K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.9% | 780 | 690 | $55K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.2% | 449 | 350 | $36K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 270 | 226 | $21K |
| 90674 | <1% | 1,201 | 1,022 | $20K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,372 | 1,117 | $19K |
67 more codes
| 96125 | <1% | 532 | $16K | |
| 99497 | <1% | 954 | $15K | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 289 | $15K |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | <1% | 636 | $14K |
| 0012A | <1% | 370 | $14K | |
| 0011A | <1% | 378 | $12K | |
| 90837 | Psychotherapy session, about an hour | <1% | 177 | $12K |
| 96127 | <1% | 2,177 | $12K | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 628 | $10K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 689 | $8K |
| 99232 | Hospital visit by a doctor, follow-up day | <1% | 162 | $7K |
| 90962 | <1% | 127 | $7K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 60 | $5K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 164 | $5K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 2,034 | $5K |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 60 | $4K |
| 0013A | <1% | 120 | $4K | |
| 81002 | <1% | 2,562 | $4K | |
| 90661 | <1% | 162 | $3K | |
| 90688 | <1% | 213 | $3K | |
| 93000 | <1% | 183 | $2K | |
| 0134A | <1% | 55 | $2K | |
| 71270 | <1% | 66 | $2K | |
| 94010 | <1% | 56 | $1K | |
| 90756 | <1% | 52 | $808.80 | |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 22 | $646.74 |
| 95251 | <1% | 82 | $594.89 | |
| 99397 | <1% | 81 | $471.68 | |
| 0004A | <1% | 18 | $452.98 | |
| 90961 | <1% | 29 | $352.68 | |
| 90694 | <1% | 117 | $247.66 | |
| G0442 | Annual alcohol misuse screening, 5 to 15 minutes | <1% | 1,315 | $175.00 |
| 99000 | <1% | 58 | $173.85 | |
| 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) | <1% | 513 | $138.00 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 38 | $80.53 |
| 99491 | Ccm add 20min | <1% | 14 | $69.48 |
| G0444 | Annual depression screening, 5 to 15 minutes | <1% | 135 | $50.00 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 19 | $17.72 |
| 96161 | <1% | 750 | $17.12 | |
| 1160F | 0% | 1,767 | $0.00 | |
| 1159F | 0% | 1,596 | $0.00 | |
| 98960 | 0% | 826 | $0.00 | |
| 2014F | 0% | 452 | $0.00 | |
| 1494F | 0% | 63 | $0.00 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 14 | $0.00 |
| 3288F | 0% | 210 | $0.00 | |
| 99071 | 0% | 17 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 154 | $0.00 |
| 91313 | 0% | 55 | $0.00 | |
| 90653 | 0% | 57 | $0.00 | |
| 1090F | 0% | 17 | $0.00 | |
| 91300 | 0% | 23 | $0.00 | |
| 1003F | 0% | 17 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 198 | $0.00 |
| M1296 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 439 | $0.00 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 244 | $0.00 |
| 4000F | 0% | 212 | $0.00 | |
| 91301 | 0% | 781 | $0.00 | |
| 1170F | 0% | 17 | $0.00 | |
| 1000F | 0% | 121 | $0.00 | |
| 91306 | 0% | 87 | $0.00 | |
| 1130F | 0% | 17 | $0.00 | |
| 1055F | 0% | 17 | $0.00 | |
| 81001 | 0% | 40 | $0.00 | |
| 99385 | 0% | 14 | $0.00 | |
| 3008F | 0% | 14 | $0.00 | |
| 90673 | 0% | 16 | $0.00 |
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 officialARORA, PRATHEEP (PRESIDENT)