Based on public Medicaid payment data.
Shiva Izaddoust
Medicaid Provider in San Antonio, TX
Type
Individual Provider
Address
2310 Sw Military Dr
San Antonio, TX 782241407
Phone
2109271400
NPI
1649317421
Procedures
3
Total Claims
14.6K
Patients Served
12.1K
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 | $34.31 | 11,323 | 10,490 |
| Dental Filling | $73.69 | 3,274 | 1,557 |
| Tooth Extraction | $131.26 | 38 | 12 |
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