Based on public Medicaid payment data.
Alex Provo
Medicaid Provider in Ada, MN
Type
Individual Provider
Address
200 E Main St
Ada, MN 565101354
Phone
2187847119
NPI
1750762555
Procedures
3
Total Claims
4K
Patients Served
3.2K
About these costs
All amounts reflect Medicaid reimbursement rates, which are typically much lower than private insurance or cash prices. These figures show what state Medicaid programs actually paid this provider per claim.
Procedures & Average Costs
| Procedure | Avg. Paid | Claims | Patients |
|---|---|---|---|
| Dental Cleaning & Exam | $57.40 | 2,131 | 2,131 |
| Tooth Extraction | $139.87 | 1,002 | 397 |
| Dental Filling | $157.65 | 905 | 652 |
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