Based on public Medicaid payment data.
Prasanth Dommaraju
Medicaid Provider in Chicago, IL
Type
Individual Provider
Address
3924 S Archer Ave
Chicago, IL 606321116
Phone
7738197101
NPI
1497317515
Procedures
4
Total Claims
16.6K
Patients Served
14.4K
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 | $30.68 | 12,955 | 12,069 |
| Tooth Extraction | $79.07 | 2,090 | 1,322 |
| Dental Filling | $65.03 | 1,412 | 879 |
| Dental Crown | $287.44 | 161 | 132 |
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