Based on public Medicaid payment data.
Sandy Charito Gramajo Cifuentes
Medicaid Provider in Pomona, CA
Type
Individual Provider
Address
510 E 3Rd St Apt 411
Pomona, CA 917661904
Phone
7138342437
NPI
1992475487
Procedures
2
Total Claims
412
Patients Served
369
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 | $70.93 | 309 | 309 |
| Dental Filling | $64.63 | 103 | 60 |
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