Medicaid Provider Spending

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

SOUZA, SERGIO

NPI: 1952778532 · LITCHFIELD PARK, AZ 85340 · Dentist · NPI assigned 08/30/2015

OIG Excluded Provider · This provider appears on the HHS Office of Inspector General List of Excluded Individuals/Entities. Exclusion date: 11/20/2024.
$0.00
Total Medicaid Paid
384
Total Claims
335
Beneficiaries
7
Codes Billed
2018-01
First Month
2019-03
Last Month

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 311 $0.00
2019 73 $0.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0220 Intraoral - periapical first radiographic image 111 91 $0.00
D1120 Prophylaxis - child 35 31 $0.00
D0274 Bitewings - four radiographic images 17 14 $0.00
D1110 Prophylaxis - adult 13 12 $0.00
D0120 Periodic oral evaluation - established patient 119 107 $0.00
D0230 Intraoral - periapical each additional radiographic image 50 44 $0.00
D1206 Topical application of fluoride varnish 39 36 $0.00