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Based on public Medicaid payment data.

Andriani Ongkorahardjo

Medicaid Provider in Diamond Bar, CA

Type

Individual Provider

Address

660 N Diamond Bar Blvd Ste 288

Diamond Bar, CA 917651070

Phone

9093960107

NPI

1902941669

Procedures

4

Total Claims

15K

Patients Served

13.6K

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 $48.51 12,071 12,013
Dental Filling $66.88 2,825 1,579
Tooth Extraction $57.40 47 24
Root Canal $99.40 19 13

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