Medicaid Provider Spending
$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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SOUTHMORE DENTAL PA
NPI: 1992495485 · PASADENA, TX 77502 ·
1223G0001X
$15K
Total Medicaid Paid
962
Total Claims
827
Beneficiaries
10
Codes Billed
2024-04
First Month
2024-12
Last Month
Monthly Spending Trend
Yearly Breakdown
Year
Claims
Total Paid
2024
962
$15K
Billing Codes
Code
Description
Claims
Beneficiaries
Total Paid
D0120
116
116
$3K
D0240
256
128
$2K
D1120
59
59
$2K
D1208
138
138
$2K
D1110
31
31
$2K
D0272
56
56
$1K
D0220
121
115
$1K
D0274
32
32
$1K
D0230
77
77
$668.74
D0601
76
75
$0.00