Based on public Medicaid payment data.
Ublester Gomez
Medicaid Provider in Pomona, CA
Type
Individual Provider
Address
12 Rancho Camino Dr
Pomona, CA 917667005
Phone
9098658500
NPI
1386770568
Procedures
3
Total Claims
3.6K
Patients Served
3.5K
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 | $55.09 | 3,492 | 3,474 |
| Dental Filling | $57.98 | 56 | 37 |
| Dental Crown | $476.00 | 26 | 16 |
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