Based on public Medicaid payment data.
Stefan Jacob Gelven
Medicaid Provider in Ponca City, OK
Type
Individual Provider
Address
503 N 14Th St
Ponca City, OK 746014655
Phone
5802002282
NPI
1063008316
Procedures
2
Total Claims
2K
Patients Served
428
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 |
|---|---|---|---|
| Tooth Extraction | $113.37 | 1,847 | 263 |
| Dental Cleaning & Exam | $28.70 | 165 | 165 |
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