Based on public Medicaid payment data.
Andrew Wilson Dethloff
Medicaid Provider in Monument, CO
Type
Individual Provider
Address
1777 Lake Woodmoor Dr
Monument, CO 801329074
Phone
7194883014
NPI
1548893928
Procedures
2
Total Claims
3.5K
Patients Served
3.4K
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 | $34.41 | 3,412 | 3,408 |
| Dental Filling | $125.20 | 41 | 29 |
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