Based on public Medicaid payment data.
Quanli Dong
Medicaid Provider in Santa Rosa, CA
Type
Individual Provider
Address
4100 Montgomery Dr
Santa Rosa, CA 954055282
Phone
7075372021
NPI
1942418264
Procedures
4
Total Claims
35.9K
Patients Served
29K
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 | $52.84 | 23,493 | 23,406 |
| Dental Filling | $63.37 | 11,636 | 5,014 |
| Tooth Extraction | $103.28 | 583 | 377 |
| Dental Crown | $457.29 | 189 | 158 |
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