Based on public Medicaid payment data.
Maxime Bouvagnet
Medicaid Provider in Chicago, IL
Type
Individual Provider
Address
4641 W Diversey Ave
Chicago, IL 606391828
Phone
7736924147
NPI
1295428803
Procedures
2
Total Claims
915
Patients Served
914
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 | $36.23 | 901 | 901 |
| Dental Filling | $73.05 | 14 | 13 |
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