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Based on public Medicaid payment data.

Chace Derrick Mickelson

Medicaid Provider in Coeur D Alene, ID

Type

Individual Provider

Address

1090 W Park Pl

Coeur D Alene, ID 838142785

Phone

2082920303

NPI

1184035115

Procedures

3

Total Claims

847

Patients Served

762

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 $0.00 587 587
Dental Filling $0.00 195 139
Tooth Extraction $0.00 65 36

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