Based on public Medicaid payment data.
Gundong Lee
Medicaid Provider in Ontario, CA
Type
Individual Provider
Address
2800 E Riverside Dr Apt 113
Ontario, CA 917617486
Phone
9098001994
NPI
1366812026
Procedures
4
Total Claims
5.6K
Patients Served
4.9K
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 | $67.26 | 4,032 | 4,023 |
| Dental Filling | $63.81 | 1,215 | 688 |
| Tooth Extraction | $118.51 | 203 | 113 |
| Dental Crown | $476.00 | 148 | 112 |
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