Based on public Medicaid payment data.
Donghan Kim
Medicaid Provider in Rancho Cucamonga, CA
Type
Individual Provider
Address
7333 Hellman Ave
Rancho Cucamonga, CA 917301302
Phone
9094830600
NPI
1801319157
Procedures
4
Total Claims
4.7K
Patients Served
4.2K
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 | $53.84 | 3,521 | 3,519 |
| Tooth Extraction | $117.32 | 657 | 394 |
| Dental Filling | $64.99 | 315 | 143 |
| Dental Crown | $475.29 | 167 | 136 |
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