Based on public Medicaid payment data.
Tanner Gray
Medicaid Provider in Holloman Afb, NM
Type
Individual Provider
Address
49 Mdg, 280 David L. Goldfein Street, Bldg 20
Holloman Afb, NM 88330
Phone
5755728099
NPI
1114509080
Procedures
3
Total Claims
1.9K
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 |
|---|---|---|---|
| Dental Cleaning & Exam | $28.50 | 1,796 | 1,794 |
| Dental Filling | $75.16 | 90 | 52 |
| Tooth Extraction | $69.43 | 21 | 15 |
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