Based on public Medicaid payment data.
Diego Bonilla
Medicaid Provider in San Antonio, TX
Type
Individual Provider
Address
5202 Texana Dr Apt 536
San Antonio, TX 782493793
Phone
8179371411
NPI
1275947228
Procedures
2
Total Claims
246
Patients Served
222
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 | $24.83 | 216 | 209 |
| Dental Filling | $50.36 | 30 | 13 |
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