Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TN › FRANKLIN › SOH OF TENNESSEE SPECIALTY LLC

SOH OF TENNESSEE SPECIALTY LLC

NPI: 1447953245 · FRANKLIN, TN 37067 · Pediatric Dentist · NPI assigned 03/22/2023

$11K
Total Medicaid Paid
389
Total Claims
383
Beneficiaries
6
Codes Billed
2024-04
First Month
2024-12
Last Month

Provider Details

Authorized OfficialSUNSHINE, ASHLY (CREDENTIALING)
Parent OrganizationSOH OF TENNESSEE SPECIALTY LLC
NPI Enumeration Date03/22/2023

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 MISSOURI SAMSON LIU PC WELDON SPRING MO $213.82

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 389 $11K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D1120 Prophylaxis - child 156 154 $5K
D0150 Comprehensive oral evaluation - new or established patient 110 109 $3K
D0330 Panoramic radiographic image 28 28 $1K
D0272 Bitewings - two radiographic images 55 54 $706.90
D0120 Periodic oral evaluation - established patient 27 26 $601.51
D9230 Inhalation of nitrous oxide / analgesia, anxiolysis 13 12 $395.46