Based on public Medicaid payment data.
Rita Lui
Medicaid Provider in Pomona, CA
Type
Individual Provider
Address
175 W La Verne Ave
Pomona, CA 917672347
Phone
9095935515
NPI
1164579835
Procedures
3
Total Claims
5.3K
Patients Served
5K
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 | $35.87 | 5,145 | 4,899 |
| Dental Filling | $45.35 | 164 | 85 |
| Tooth Extraction | $57.40 | 33 | 12 |
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