Based on public Medicaid payment data.
Annie Hsu
Medicaid Provider in Cupertino, CA
Type
Individual Provider
Address
20480 Pacifica Dr Ste E2
Cupertino, CA 950143015
Phone
4082535473
NPI
1740836782
Procedures
5
Total Claims
16.2K
Patients Served
11.8K
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 | $73.50 | 7,295 | 7,295 |
| Dental Filling | $66.63 | 7,059 | 3,292 |
| Tooth Extraction | $111.96 | 1,329 | 874 |
| Dental Crown | $474.82 | 504 | 293 |
| Root Canal | $302.40 | 23 | 12 |
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