Based on public Medicaid payment data.
Marisa Ann Lopez
Medicaid Provider in Charlotte, NC
Type
Individual Provider
Address
11835 Southmore Dr Ste 201
Charlotte, NC 282774820
Phone
9739412614
NPI
1972844264
Procedures
3
Total Claims
23.2K
Patients Served
21.8K
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 | $31.47 | 20,111 | 19,871 |
| Dental Filling | $73.47 | 2,502 | 1,575 |
| Tooth Extraction | $60.42 | 573 | 389 |
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