Based on public Medicaid payment data.
Indraja Chacko
Medicaid Provider in Edmond, OK
Type
Individual Provider
Address
16401 Ironstone Dr
Edmond, OK 730136088
Phone
4057844822
NPI
1447099734
Procedures
2
Total Claims
282
Patients Served
272
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 | $34.99 | 249 | 249 |
| Dental Filling | $124.57 | 33 | 23 |
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