Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MO › WELDON SPRING › SOH OF MISSOURI SAMSON LIU PC

SOH OF MISSOURI SAMSON LIU PC

NPI: 1427550078 · WELDON SPRING, MO 63304 · Dentist · NPI assigned 02/28/2018

$213.82
Total Medicaid Paid
195
Total Claims
100
Beneficiaries
5
Codes Billed
2020-02
First Month
2020-02
Last Month

Provider Details

Authorized OfficialSUNSHINE, ASHLY (CREDENTIALING SPECIALIST)
NPI Enumeration Date02/28/2018

Related Entities

Other providers sharing the same authorized official: SUNSHINE, ASHLY

ProviderCityStateTotal Paid
SOH OF TEXAS SAMSON LIU PLLC DESOTO TX $3.60M
PEARL FAMILY DENTAL CARE, INC PEARL CITY HI $419K
SOH OF TENNESSEE SPECIALTY LLC FRANKLIN TN $11K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2020 195 $213.82

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 51 25 $156.32
D0330 Panoramic radiographic image 36 19 $36.18
D0274 Bitewings - four radiographic images 37 21 $21.32
D1110 Prophylaxis - adult 30 15 $0.00
D1206 Topical application of fluoride varnish 41 20 $0.00