Based on public Medicaid payment data.
Kimberly Ellen Rostvold
Medicaid Provider in Hermantown, MN
Type
Individual Provider
Address
4419 Air Base Rd
Hermantown, MN 558111847
Phone
2187282117
NPI
1417479700
Procedures
3
Total Claims
2.2K
Patients Served
2K
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 | $113.68 | 1,778 | 1,776 |
| Dental Filling | $163.01 | 364 | 251 |
| Tooth Extraction | $181.21 | 22 | 12 |
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