Based on public Medicaid payment data.
Marta Calvo
Medicaid Provider in Ontario, CA
Type
Individual Provider
Address
1051 N Mountain Ave
Ontario, CA 917622157
Phone
9099881800
NPI
1184863656
Procedures
5
Total Claims
15.6K
Patients Served
13.9K
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 | $55.43 | 11,880 | 11,839 |
| Tooth Extraction | $82.45 | 1,590 | 776 |
| Dental Filling | $73.27 | 1,416 | 889 |
| Dental Crown | $475.46 | 658 | 390 |
| Root Canal | $463.40 | 13 | 12 |
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