Based on public Medicaid payment data.
Koua Xiong
Medicaid Provider in Rice Lake, WI
Type
Individual Provider
Address
1501 W Stout St
Rice Lake, WI 548685001
Phone
4147371599
NPI
1417278292
Procedures
3
Total Claims
18.9K
Patients Served
16.4K
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 | $18.04 | 13,179 | 12,679 |
| Dental Filling | $43.39 | 3,985 | 2,806 |
| Tooth Extraction | $36.16 | 1,761 | 935 |
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