Based on public Medicaid payment data.
Jonathan Polk Wimer
Medicaid Provider in Summerville, SC
Type
Individual Provider
Address
176 Tyvola Drive
Summerville, SC 29485
Phone
8438324560
NPI
1629125562
Procedures
2
Total Claims
158
Patients Served
155
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 | $34.83 | 142 | 142 |
| Dental Filling | $79.42 | 16 | 13 |
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