Based on public Medicaid payment data.
Derek B. Tom
Medicaid Provider in Aiea, HI
Type
Individual Provider
Address
98-150 Kaonohi St
Aiea, HI 967015047
Phone
8084880100
NPI
1770667131
Procedures
4
Total Claims
43.5K
Patients Served
41.4K
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 | $28.51 | 38,304 | 38,289 |
| Dental Filling | $51.34 | 3,380 | 1,990 |
| Root Canal | $64.43 | 977 | 551 |
| Tooth Extraction | $44.61 | 798 | 600 |
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