Based on public Medicaid payment data.
Kevin Dietiker
Medicaid Provider in Louisville, CO
Type
Individual Provider
Address
877 E South Boulder Rd # Rx
Louisville, CO 800271345
Phone
3036658228
NPI
1316526379
Procedures
2
Total Claims
1.5K
Patients Served
1.4K
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 | $36.78 | 1,145 | 1,132 |
| Dental Filling | $132.52 | 386 | 254 |
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