Based on public Medicaid payment data.
Jacqueline Revello
Medicaid Provider in Divide, CO
Type
Individual Provider
Address
11115 W. Hwy 24, Unit 2C
Divide, CO 80814
Phone
7196876416
NPI
1003084369
Procedures
1
Total Claims
75
Patients Served
75
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 |
|---|---|---|---|
| Vaccines & Immunizations | $12.90 | 75 | 75 |
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