Based on public Medicaid payment data.
Sam Wise
Medicaid Provider in Rockwall, TX
Type
Individual Provider
Address
3045 N Goliad St Ste 105
Rockwall, TX 750877097
Phone
9727229100
NPI
1417416728
Procedures
2
Total Claims
536
Patients Served
425
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 | $31.70 | 453 | 411 |
| Tooth Extraction | $105.19 | 83 | 14 |
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