Based on public Medicaid payment data.
Jeanine Alicia Gourdine
Medicaid Provider in Summerville, SC
Type
Individual Provider
Address
100 Omalley Dr
Summerville, SC 294835635
Phone
8432610123
NPI
1427014786
Procedures
4
Total Claims
10.9K
Patients Served
10.5K
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 | $33.92 | 9,502 | 9,502 |
| Dental Filling | $95.11 | 1,312 | 952 |
| Tooth Extraction | $85.51 | 57 | 41 |
| Root Canal | $81.86 | 34 | 30 |
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