Based on public Medicaid payment data.
Sima Sam
Medicaid Provider in Rockford, IL
Type
Individual Provider
Address
1200 W State St
Rockford, IL 611022112
Phone
8154901600
NPI
1982617478
Procedures
4
Total Claims
27.9K
Patients Served
26.5K
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 | $33.56 | 23,551 | 22,808 |
| Dental Filling | $49.01 | 3,874 | 3,305 |
| Tooth Extraction | $45.04 | 410 | 350 |
| Root Canal | $52.70 | 15 | 15 |
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