Based on public Medicaid payment data.
David Ira Konicov
Medicaid Provider in Providence, RI
Type
Individual Provider
Address
189 Governor St
Providence, RI 029063124
Phone
4014211457
NPI
1033264866
Procedures
3
Total Claims
10K
Patients Served
9.3K
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 | $20.93 | 9,237 | 8,847 |
| Tooth Extraction | $63.88 | 737 | 426 |
| Dental Filling | $40.83 | 12 | 12 |
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