Based on public Medicaid payment data.
Jordan Pellegrom
Medicaid Provider in Sartell, MN
Type
Individual Provider
Address
140 Twin Rivers Ct
Sartell, MN 563772015
Phone
3202573380
NPI
1639806326
Procedures
2
Total Claims
941
Patients Served
903
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 | $33.14 | 921 | 889 |
| Dental Filling | $59.08 | 20 | 14 |
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