Based on public Medicaid payment data.
Michael Moon
Medicaid Provider in Sulphur, OK
Type
Individual Provider
Address
2611 W Broadway Ave
Sulphur, OK 730866518
Phone
5806226655
NPI
1336871995
Procedures
3
Total Claims
1.3K
Patients Served
1.2K
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 | $33.11 | 1,234 | 1,194 |
| Dental Filling | $149.22 | 39 | 27 |
| Tooth Extraction | $127.00 | 19 | 12 |
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