Based on public Medicaid payment data.
Wael Sameer Victor
Medicaid Provider in Pomona, CA
Type
Individual Provider
Address
763 Rio Rancho Rd Ste 120
Pomona, CA 917667015
Phone
9092427989
NPI
1073343240
Procedures
3
Total Claims
363
Patients Served
256
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 Filling | $61.00 | 202 | 113 |
| Dental Cleaning & Exam | $63.99 | 102 | 102 |
| Dental Crown | $476.00 | 59 | 41 |
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