Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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TLA DDS PLLC

NPI: 1073258471 · CROOKSTON, MN 56716 · Dental Clinic/Center · NPI assigned 04/29/2022

$18K
Total Medicaid Paid
459
Total Claims
459
Beneficiaries
4
Codes Billed
2022-10
First Month
2024-09
Last Month

Provider Details

Authorized OfficialAPPLEQUIST, TIARA (OWNER)
NPI Enumeration Date04/29/2022

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 54 $2K
2023 245 $10K
2024 160 $7K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 270 270 $10K
D1110 Prophylaxis - adult 109 109 $6K
D1208 Topical application of fluoride, excluding varnish 68 68 $2K
D0274 Bitewings - four radiographic images 12 12 $540.48