Based on public Medicaid payment data.
Breanna Michele Costa
Medicaid Provider in Knoxville, TN
Type
Individual Provider
Address
264 S Peters Rd
Knoxville, TN 379235203
Phone
8655391776
NPI
1811443153
Procedures
3
Total Claims
4.9K
Patients Served
3.9K
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 | $29.95 | 3,200 | 3,064 |
| Dental Filling | $68.86 | 1,577 | 805 |
| Tooth Extraction | $63.88 | 109 | 66 |
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