Based on public Medicaid payment data.
Sari Ratna Manap
Medicaid Provider in Rochester, NY
Type
Individual Provider
Address
1901 Lac De Ville Blvd
Rochester, NY 146185660
Phone
5854611200
NPI
1386054799
Procedures
4
Total Claims
11.5K
Patients Served
10.5K
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 | $36.45 | 8,779 | 8,777 |
| Dental Filling | $72.39 | 2,067 | 1,304 |
| Tooth Extraction | $57.09 | 629 | 392 |
| Root Canal | $93.30 | 69 | 49 |
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