Based on public Medicaid payment data.
Susanti Rahaju Ie
Medicaid Provider in Roanoke, VA
Type
Individual Provider
Address
2001 Crystal Spring Ave Sw
Roanoke, VA 240142462
Phone
5409858505
NPI
1215910781
Procedures
4
Total Claims
3.2K
Patients Served
2.3K
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 |
|---|---|---|---|
| Emergency Room Visit | $103.17 | 1,152 | 403 |
| Sleep Study (Polysomnography) | $34.15 | 908 | 852 |
| Office Visit | $56.36 | 773 | 710 |
| Pulmonary Function Test | $6.15 | 363 | 350 |
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