Based on public Medicaid payment data.
Matthew O. Jensen
Medicaid Provider in Surprise, AZ
Type
Individual Provider
Address
15331 W Bell Rd Ste 112
Surprise, AZ 853744103
Phone
6027306481
NPI
1982703427
Procedures
4
Total Claims
25.1K
Patients Served
21.1K
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 | $5.82 | 18,824 | 18,258 |
| Dental Filling | $10.67 | 4,829 | 2,206 |
| Tooth Extraction | $16.24 | 872 | 463 |
| Root Canal | $22.77 | 534 | 221 |
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