Based on public Medicaid payment data.
Didik Suhardjo
Medicaid Provider in Los Angeles, CA
Type
Individual Provider
Address
749 S Union Ave
Los Angeles, CA 900172115
Phone
2134835616
NPI
1427078211
Procedures
4
Total Claims
11.8K
Patients Served
11.5K
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 | $60.05 | 9,467 | 9,457 |
| Root Canal | $439.59 | 1,226 | 1,134 |
| Dental Filling | $67.27 | 1,007 | 771 |
| Dental Crown | $476.00 | 130 | 107 |
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