Based on public Medicaid payment data.
Mohammad Masoudian Khouzani
Medicaid Provider in Goldendale, WA
Type
Individual Provider
Address
310 S Roosevelt St
Goldendale, WA 986209201
Phone
5097734022
NPI
1588425169
Procedures
3
Total Claims
799
Patients Served
691
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 | $39.73 | 517 | 491 |
| Dental Filling | $67.26 | 254 | 184 |
| Tooth Extraction | $119.60 | 28 | 16 |
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