Based on public Medicaid payment data.
Samantha Rae Didomenico
Medicaid Provider in Las Animas, CO
Type
Individual Provider
Address
245 Vine Ave
Las Animas, CO 81054
Phone
7194562653
NPI
1891241527
Procedures
3
Total Claims
2.3K
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 | $38.85 | 1,890 | 1,687 |
| Tooth Extraction | $115.52 | 286 | 114 |
| Dental Filling | $147.31 | 120 | 74 |
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