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Based on public Medicaid payment data.

Jack I Lee

Medicaid Provider in Ontario, CA

Type

Individual Provider

Address

961 N Milliken Ave Ste 103

Ontario, CA 917645022

Phone

9095817700

NPI

1518985886

Procedures

1

Total Claims

24

Patients Served

24

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 $57.92 24 24

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