Based on public Medicaid payment data.
Alita Darmayanti Lubis
Medicaid Provider in Greenville, SC
Type
Individual Provider
Address
6134 White Horse Rd Ste C
Greenville, SC 296113847
Phone
8642952744
NPI
1598477838
Procedures
3
Total Claims
3K
Patients Served
2.8K
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 | $37.19 | 2,495 | 2,492 |
| Dental Filling | $96.22 | 296 | 183 |
| Tooth Extraction | $95.67 | 225 | 116 |
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