Based on public Medicaid payment data.
Celia Ponce Octoman
Medicaid Provider in Los Angeles, CA
Type
Individual Provider
Address
2023 Beverly Blvd
Los Angeles, CA 900572417
Phone
2133539930
NPI
1790963890
Procedures
5
Total Claims
6.4K
Patients Served
5.6K
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 | $70.09 | 4,604 | 4,598 |
| Dental Filling | $62.69 | 1,192 | 604 |
| Tooth Extraction | $112.38 | 296 | 173 |
| Dental Crown | $476.00 | 279 | 158 |
| Root Canal | $463.40 | 33 | 24 |
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