Based on public Medicaid payment data.
Andrzej Lubczuk
Medicaid Provider in Fontana, CA
Type
Individual Provider
Address
9193 Sierra Ave Ste D
Fontana, CA 923354776
Phone
9098222226
NPI
1760574867
Procedures
5
Total Claims
8.6K
Patients Served
7.9K
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 | $60.60 | 7,127 | 7,047 |
| Dental Crown | $475.32 | 1,020 | 567 |
| Dental Filling | $62.44 | 155 | 90 |
| Tooth Extraction | $118.20 | 148 | 78 |
| Root Canal | $450.87 | 133 | 112 |
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