Medicaid Provider Spending

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

KYLE R DANIELSON, DDS, PLLC

NPI: 1750930525 · SPRING PARK, MN 55384 · Dental Clinic/Center · NPI assigned 09/05/2019

$8K
Total Medicaid Paid
290
Total Claims
275
Beneficiary Records
7
Codes Billed
2022-05
First Month
2024-10
Last Month

Provider Details

Authorized OfficialDANIELSON, KYLE (OWNER)
NPI Enumeration Date09/05/2019

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2022 240 $7K
2023 13 $408.13
2024 37 $1K

Billing Codes

CodeDescriptionClaimsBene. RecordsTotal Paid
D0150 Comprehensive oral evaluation - new or established patient 64 64 $2K
D0274 Bitewings - four radiographic images 52 52 $2K
D1110 Prophylaxis - adult 28 28 $1K
D0120 Periodic oral evaluation - established patient 37 37 $1K
D0220 Intraoral - periapical first radiographic image 63 56 $762.89
D1206 Topical application of fluoride varnish 25 25 $704.94
D0230 Intraoral - periapical each additional radiographic image 21 13 $208.05