Based on public Medicaid payment data.
Percival Frederick Dacosta
Medicaid Provider in Dayton, OH
Type
Individual Provider
Address
2234 Salem Ave
Dayton, OH 454065627
Phone
9372780891
NPI
1356554778
Procedures
1
Total Claims
1.4K
Patients Served
1.4K
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 | $26.77 | 1,427 | 1,388 |
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