Based on public Medicaid payment data.
Ivan Jonathan Santos
Medicaid Provider in Lakeside, CA
Type
Individual Provider
Address
12110 Woodside Ave
Lakeside, CA 920403012
Phone
6194430444
NPI
1659730182
Procedures
5
Total Claims
13K
Patients Served
9.3K
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 Filling | $67.59 | 5,504 | 2,958 |
| Dental Cleaning & Exam | $75.46 | 4,568 | 4,525 |
| Dental Crown | $475.55 | 1,572 | 1,050 |
| Tooth Extraction | $59.22 | 671 | 216 |
| Root Canal | $407.16 | 640 | 540 |
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