Based on public Medicaid payment data.
Jui-Min Su
Medicaid Provider in Ontario, CA
Type
Individual Provider
Address
4275 E. Concours,
Ontario, CA 917645901
Phone
9517360876
NPI
1841216561
Procedures
3
Total Claims
9.3K
Patients Served
8.8K
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 | $50.99 | 8,355 | 8,315 |
| Dental Filling | $62.12 | 494 | 322 |
| Tooth Extraction | $57.40 | 407 | 183 |
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