Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

SUMMIT MEDICAL CLINIC, PC

NPI: 1992709653 · COLORADO SPRINGS, CO 80907 · Internal Medicine Physician · NPI assigned 06/10/2005

$2.93M
Total Medicaid Paid
134,006
Total Claims
89,009
Beneficiaries
79
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialARORA, PRATHEEP (PRESIDENT)
NPI Enumeration Date06/10/2005

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 16,383 $277K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 27,989 17,219 $1.35M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 20,654 15,315 $844K
G8510 Screening for depression is documented as negative, a follow-up plan is not required 41,149 26,056 $133K
99406 11,602 7,281 $83K
90832 Psychotherapy, 30 minutes with patient 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 1,495 1,074 $57K
90791 Psychiatric diagnostic evaluation 1,062 711 $57K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 780 690 $55K
99215 Prolong outpt/office vis 449 350 $36K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 270 226 $21K
90674 1,201 1,022 $20K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,372 1,117 $19K
96125 532 295 $16K
99497 954 728 $15K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 289 129 $15K
G0108 Diabetes outpatient self-management training services, individual, per 30 minutes 636 385 $14K
0012A 370 363 $14K
0011A 378 366 $12K
90837 Psychotherapy, 53 minutes with patient 177 108 $12K
96127 2,177 1,509 $12K
G8431 Screening for depression is documented as being positive and a follow-up plan is documented 628 520 $10K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 689 561 $8K
99232 Subsequent hospital care, per day, moderate complexity 162 60 $7K
90962 127 35 $7K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 60 55 $5K
90834 Psychotherapy, 45 minutes with patient 164 81 $5K
83036 Hemoglobin; glycosylated (A1C) 2,034 1,075 $5K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets 60 54 $4K
0013A 120 116 $4K
81002 2,562 1,839 $4K
90661 162 117 $3K
90688 213 195 $3K
93000 183 159 $2K
0134A 55 43 $2K
71270 66 49 $2K
94010 56 45 $1K
90756 52 49 $808.80
90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) 22 19 $646.74
95251 82 47 $594.89
99397 81 45 $471.68
0004A 18 18 $452.98
90961 29 12 $352.68
90694 117 65 $247.66
G0442 Annual alcohol misuse screening, 5 to 15 minutes 1,315 1,008 $175.00
99000 58 56 $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) 513 361 $138.00
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only 38 29 $80.53
99491 Ccm add 20min 14 12 $69.48
G0444 Annual depression screening, 5 to 15 minutes 135 92 $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 19 17 $17.72
96161 750 611 $17.12
1160F 1,767 1,217 $0.00
1159F 1,596 1,142 $0.00
98960 826 625 $0.00
2014F 452 321 $0.00
1494F 63 40 $0.00
G8427 Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications 14 12 $0.00
3288F 210 149 $0.00
99071 17 14 $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) 154 121 $0.00
91313 55 43 $0.00
90653 57 47 $0.00
1090F 17 14 $0.00
91300 23 23 $0.00
1003F 17 14 $0.00
G0008 Administration of influenza virus vaccine 198 136 $0.00
M1296 Bmi is documented within normal parameters and no follow-up plan is required 439 312 $0.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit 244 177 $0.00
4000F 212 176 $0.00
91301 781 738 $0.00
1170F 17 14 $0.00
1000F 121 68 $0.00
91306 87 86 $0.00
1130F 17 14 $0.00
1055F 17 14 $0.00
81001 40 28 $0.00
99385 14 12 $0.00
3008F 14 13 $0.00
90673 16 16 $0.00