Based on public Medicaid payment data.
Ethan Harrison Perellis
Medicaid Provider in Louisville, KY
Type
Individual Provider
Address
9451 Westport Rd Ste 109
Louisville, KY 402412295
Phone
5024125900
NPI
1629642079
Procedures
2
Total Claims
744
Patients Served
709
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 | $33.54 | 642 | 624 |
| Dental Filling | $53.91 | 102 | 85 |
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