Medicaid Provider Spending

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

NPI: 1962918094 · ST. GEORGE, UT 84790 · Oral & Maxillofacial Surgery (D.M.D.) · NPI assigned 12/27/2017

$36K
Total Medicaid Paid
303
Total Claims
196
Beneficiaries
5
Codes Billed
2018-03
First Month
2018-04
Last Month

Provider Details

Authorized OfficialDAVIS, SHAWN (OWNER)
NPI Enumeration Date12/27/2017

Related Entities

Other providers sharing the same authorized official: DAVIS, SHAWN

ProviderCityStateTotal Paid
TEXARKANA IND SCHOOL DISTRICT TEXARKANA TX $1.66M
PRIME HEALTH PHYSICAL THERAPY LINDEN NJ $194K
BEST PHYSICAL THERAPY, INC LINDEN NJ $40K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 303 $36K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 47 47 $18K
D0330 Panoramic radiographic image 36 36 $11K
D9222 38 38 $6K
D7240 Removal of impacted tooth - completely bony 138 37 $192.46
D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment 44 38 $117.00