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Based on public Medicaid payment data.

Sebastian M Bouroncle

Medicaid Provider in Stafford, VA

Type

Individual Provider

Address

385 Garrisonville Rd

Stafford, VA 225541545

Phone

5406577645

NPI

1932245511

Procedures

5

Total Claims

23.3K

Patients Served

19.1K

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 $21.36 14,786 14,099
Dental Filling $68.21 7,491 4,236
Dental Crown $253.61 837 593
Tooth Extraction $37.25 145 67
Root Canal $460.20 75 62

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