Based on public Medicaid payment data.
Jin Kyu Lee
Medicaid Provider in Barstow, CA
Type
Individual Provider
Address
912 E Main St
Barstow, CA 923112406
Phone
7602551206
NPI
1033583992
Procedures
4
Total Claims
7K
Patients Served
6.3K
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 | $58.87 | 5,690 | 5,684 |
| Dental Filling | $59.20 | 1,047 | 488 |
| Tooth Extraction | $115.42 | 266 | 128 |
| Dental Crown | $476.00 | 27 | 21 |
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