Based on public Medicaid payment data.
Leslie Suzanne Wallace
Medicaid Provider in Lebanon, TN
Type
Individual Provider
Address
103 Physicians Way
Lebanon, TN 370904104
Phone
8599480386
NPI
1629301833
Procedures
4
Total Claims
26.4K
Patients Served
25.3K
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 | $28.85 | 24,267 | 24,122 |
| Dental Filling | $65.83 | 1,662 | 887 |
| Tooth Extraction | $63.48 | 476 | 230 |
| Root Canal | $82.87 | 19 | 12 |
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