Based on public Medicaid payment data.
Ellen Faye Campomanes Alpano
Medicaid Provider in Polacca, AZ
Type
Individual Provider
Address
Highway 264 Milepost 388
Polacca, AZ 86042
Phone
9287376167
NPI
1912036013
Procedures
3
Total Claims
8K
Patients Served
7.5K
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 | $17.86 | 7,866 | 7,417 |
| Dental Filling | $89.45 | 85 | 40 |
| Tooth Extraction | $0.00 | 60 | 24 |
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