Based on public Medicaid payment data.
Shreya Divya Lettre
Medicaid Provider in Fort Worth, TX
Type
Individual Provider
Address
4504 W Vickery Blvd
Fort Worth, TX 761076224
Phone
8173320007
NPI
1932639994
Procedures
4
Total Claims
14.5K
Patients Served
13.3K
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 | $41.58 | 12,266 | 11,899 |
| Dental Filling | $81.70 | 1,433 | 961 |
| Tooth Extraction | $43.87 | 709 | 419 |
| Root Canal | $76.75 | 93 | 62 |
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