Based on public Medicaid payment data.
Samantha Alexandria Clark
Medicaid Provider in Polson, MT
Type
Individual Provider
Address
5 4Th Ave. E.
Polson, MT 59860
Phone
4067453525
NPI
1174967277
Procedures
3
Total Claims
22.4K
Patients Served
19.3K
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 | $32.80 | 18,674 | 17,367 |
| Dental Filling | $112.14 | 3,444 | 1,844 |
| Tooth Extraction | $76.79 | 233 | 130 |
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