Based on public Medicaid payment data.
Jolly Samuel Johnson
Medicaid Provider in Fort Collins, CO
Type
Individual Provider
Address
2132 E Harmony Rd
Fort Collins, CO 805289504
Phone
9702873701
NPI
1407908742
Procedures
3
Total Claims
1.7K
Patients Served
1.3K
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 | $31.75 | 906 | 867 |
| Dental Filling | $124.47 | 798 | 409 |
| Tooth Extraction | $159.21 | 42 | 12 |
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