Based on public Medicaid payment data.
Farhana Mannan Mouri
Medicaid Provider in Modesto, CA
Type
Individual Provider
Address
2605 Coffee Rd Ste 200
Modesto, CA 953552064
Phone
2095210100
NPI
1346953387
Procedures
2
Total Claims
1.2K
Patients Served
982
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 Filling | $63.47 | 885 | 652 |
| Dental Cleaning & Exam | $68.54 | 330 | 330 |
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