Based on public Medicaid payment data.
Ellysse Canales
Medicaid Provider in San Antonio, TX
Type
Individual Provider
Address
323 Nw 24Th St
San Antonio, TX 782073209
Phone
2104366261
NPI
1750695144
Procedures
2
Total Claims
450
Patients Served
372
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 | $23.85 | 431 | 359 |
| Dental Filling | $105.02 | 19 | 13 |
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