Based on public Medicaid payment data.
Simon Lucas Mack
Medicaid Provider in Longview, TX
Type
Individual Provider
Address
3004 H.G. Mosley Pkwy
Longview, TX 75605
Phone
9037583444
NPI
1639676166
Procedures
2
Total Claims
587
Patients Served
355
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 |
|---|---|---|---|
| Tooth Extraction | $264.43 | 332 | 104 |
| Dental Cleaning & Exam | $17.84 | 255 | 251 |
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