Based on public Medicaid payment data.
Andrei Souchitski
Medicaid Provider in Los Angeles, CA
Type
Individual Provider
Address
514 E Washington Blvd
Los Angeles, CA 900153723
Phone
2137493934
NPI
1265543920
Procedures
4
Total Claims
3.3K
Patients Served
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 | $50.61 | 2,617 | 2,607 |
| Dental Filling | $60.87 | 439 | 279 |
| Root Canal | $455.56 | 144 | 124 |
| Tooth Extraction | $93.58 | 63 | 38 |
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