CENTRA SOHO PLLC
NPI: 1760028021
· SOUTH HOUSTON, TX 77587
· General Practice Dentistry
· NPI assigned 11/21/2019
$112K
Total Medicaid Paid
Provider Details
| Authorized Official | NGUYEN, KATHY (OWNER) |
| NPI Enumeration Date | 11/21/2019 |
Related Entities
Other providers sharing the same authorized official: NGUYEN, KATHY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2020 |
292 |
$5K |
| 2021 |
1,985 |
$34K |
| 2022 |
1,783 |
$30K |
| 2023 |
1,848 |
$34K |
| 2024 |
535 |
$9K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
768 |
760 |
$22K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,434 |
819 |
$15K |
| D1208 |
Topical application of fluoride, excluding varnish |
871 |
862 |
$12K |
| D0350 |
|
793 |
786 |
$12K |
| D1110 |
Prophylaxis - adult |
213 |
212 |
$12K |
| D0274 |
Bitewings - four radiographic images |
344 |
341 |
$11K |
| D0220 |
Intraoral - periapical first radiographic image |
900 |
886 |
$10K |
| D1120 |
Prophylaxis - child |
259 |
254 |
$9K |
| D1351 |
Sealant - per tooth |
334 |
61 |
$9K |
| D0602 |
|
239 |
237 |
$0.00 |
| D0603 |
|
270 |
269 |
$0.00 |
| D0601 |
|
18 |
17 |
$0.00 |