Based on public Medicaid payment data.
Moises Yldefonso Salas
Medicaid Provider in Hartford, CT
Type
Individual Provider
Address
21 Grand St
Hartford, CT 061061541
Phone
8605507500
NPI
1174512255
Procedures
3
Total Claims
13.4K
Patients Served
11.8K
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 | $13.21 | 11,764 | 10,668 |
| Dental Filling | $80.39 | 1,329 | 933 |
| Tooth Extraction | $4.57 | 345 | 224 |
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