Based on public Medicaid payment data.
Nika Lustgarten
Medicaid Provider in Portland, OR
Type
Individual Provider
Address
3181 Sw Sam Jackson Park Rd
Portland, OR 972393011
Phone
5034948211
NPI
1487005187
Procedures
3
Total Claims
3K
Patients Served
2.6K
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 | $8.51 | 2,103 | 2,039 |
| Dental Filling | $14.01 | 834 | 530 |
| Tooth Extraction | $6.96 | 67 | 50 |
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