Based on public Medicaid payment data.
Yvonne Shu Rodriguez
Medicaid Provider in Pomona, CA
Type
Individual Provider
Address
1640 Indian Hill Blvd
Pomona, CA 917673728
Phone
9094824500
NPI
1356414411
Procedures
5
Total Claims
8.6K
Patients Served
7.6K
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 | $55.79 | 6,799 | 6,780 |
| Dental Filling | $56.34 | 948 | 366 |
| Dental Crown | $468.76 | 677 | 401 |
| Root Canal | $447.20 | 97 | 81 |
| Tooth Extraction | $57.40 | 30 | 13 |
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