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Based on public Medicaid payment data.

Jessica Yoon Kyung Pack

Medicaid Provider in Los Angeles, CA

Type

Individual Provider

Address

1234 Wilshire Blvd Apt 212

Los Angeles, CA 900171974

Phone

8184277543

NPI

1013365881

Procedures

4

Total Claims

303

Patients Served

172

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 $67.20 118 56
Root Canal $99.40 88 54
Tooth Extraction $57.40 73 38
Dental Cleaning & Exam $66.00 24 24

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