Based on public Medicaid payment data.
Sandeep Thota
Medicaid Provider in Bloomington, IL
Type
Individual Provider
Address
1407 N Veterans Pkwy
Bloomington, IL 617046630
Phone
3146516550
NPI
1467835223
Procedures
4
Total Claims
57.9K
Patients Served
42.4K
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 | $31.56 | 35,636 | 33,188 |
| Tooth Extraction | $67.77 | 12,228 | 4,716 |
| Dental Filling | $75.74 | 10,060 | 4,519 |
| Dental Crown | $279.30 | 16 | 13 |
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