Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › MN › MAPLE GROVE › PDB, DDS, PA

PDB, DDS, PA

NPI: 1942809637 · MAPLE GROVE, MN 55369 · Dental Clinic/Center · NPI assigned 10/22/2020

$514.80
Total Medicaid Paid
16
Total Claims
16
Beneficiaries
1
Codes Billed
2023-10
First Month
2023-10
Last Month

Provider Details

Authorized OfficialBOETTNER, PAUL (CEO)
NPI Enumeration Date10/22/2020

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2023 16 $514.80

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 16 16 $514.80