Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › MANOR › MYDENTAL AT MANOR PLLC

MYDENTAL AT MANOR PLLC

NPI: 1083473722 · MANOR, TX 78653 · Dentist · NPI assigned 03/15/2024

$1K
Total Medicaid Paid
89
Total Claims
88
Beneficiaries
6
Codes Billed
2024-10
First Month
2024-10
Last Month

Provider Details

Authorized OfficialPATEL, JINAL (OWNER)
NPI Enumeration Date03/15/2024

Related Entities

Other providers sharing the same authorized official: PATEL, JINAL

ProviderCityStateTotal Paid
MYDENTAL AT NORWOOD PLLC AUSTIN TX $1.23M
MYDENTAL AUSTIN TX $647K
MYDENTAL AT ROUND ROCK PLLC ROUND ROCK TX $640K
MYDENTAL AT ELGIN PLLC ELGIN TX $398K
MYDENTAL AT ANDERSON MILL PLLC AUSTIN TX $265K
DEVIKA PHARMA INC ARVIN CA $15K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2024 89 $1K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 19 19 $529.80
D1208 Topical application of fluoride, excluding varnish 19 19 $264.60
D0330 Panoramic radiographic image 12 12 $133.99
D0230 Intraoral - periapical each additional radiographic image 14 13 $103.59
D0220 Intraoral - periapical first radiographic image 13 13 $100.48
D0601 12 12 $0.00