MAN-PIK LO, D.D.S., INC.
NPI: 1356731608
· CUPERTINO, CA 95014
· General Practice Dentistry
· NPI assigned 01/26/2015
$216K
Total Medicaid Paid
Provider Details
| Authorized Official | MAN-PIK, LO (OWNER) |
| NPI Enumeration Date | 01/26/2015 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2018 |
1,184 |
$52K |
| 2019 |
1,296 |
$65K |
| 2020 |
248 |
$14K |
| 2021 |
334 |
$18K |
| 2022 |
390 |
$25K |
| 2023 |
395 |
$22K |
| 2024 |
316 |
$20K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,190 |
1,188 |
$100K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
661 |
661 |
$41K |
| D9110 |
|
469 |
465 |
$29K |
| D0210 |
Intraoral - complete series of radiographic images |
589 |
587 |
$28K |
| D0230 |
Intraoral - periapical each additional radiographic image |
754 |
722 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
256 |
254 |
$3K |
| D4341 |
|
38 |
13 |
$3K |
| D2330 |
|
33 |
12 |
$3K |
| D0274 |
Bitewings - four radiographic images |
105 |
105 |
$2K |
| D1120 |
Prophylaxis - child |
34 |
34 |
$990.00 |
| D1206 |
Topical application of fluoride varnish |
34 |
34 |
$274.00 |