Based on public Medicaid payment data.
Lisa Marie Koumoulos
Medicaid Provider in Hackensack, NJ
Type
Individual Provider
Address
92 Summit Ave
Hackensack, NJ 076011263
Phone
2013420066
NPI
1700482866
Procedures
4
Total Claims
2.2K
Patients Served
1.9K
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 | $26.77 | 1,835 | 1,603 |
| EKG / ECG (Electrocardiogram) | $8.59 | 256 | 208 |
| Urinalysis & Urine Tests | $1.88 | 88 | 73 |
| Vaccines & Immunizations | $6.87 | 13 | 12 |
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