Based on public Medicaid payment data.
Donald Basil Drevna
Medicaid Provider in San Diego, CA
Type
Individual Provider
Address
4166 Monroe Ave
San Diego, CA 921164773
Phone
7605500059
NPI
1508076498
Procedures
2
Total Claims
915
Patients Served
892
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 | $65.29 | 841 | 840 |
| Dental Crown | $476.00 | 74 | 52 |
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