Based on public Medicaid payment data.
Cory Johnson
Medicaid Provider in South Salt Lake, UT
Type
Individual Provider
Address
170 E Commonwealth Ave
South Salt Lake, UT 841152712
Phone
7196608188
NPI
1902420318
Procedures
2
Total Claims
1.2K
Patients Served
975
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 | $107.55 | 658 | 631 |
| Tooth Extraction | $138.22 | 520 | 344 |
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