Based on public Medicaid payment data.
Arely Dominguez Gonzalez
Medicaid Provider in Fountain, CO
Type
Individual Provider
Address
350 Lyckman Pl
Fountain, CO 808172861
Phone
7196325700
NPI
1548826670
Procedures
2
Total Claims
163
Patients Served
144
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 |
|---|---|---|---|
| Office Visit | $186.15 | 91 | 82 |
| Vaccines & Immunizations | $0.00 | 72 | 62 |
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