Based on public Medicaid payment data.
Elizabeth Suwartono Pagler
Medicaid Provider in Rancho Cucamonga, CA
Type
Individual Provider
Address
11398 Kenyon Way Ste J
Rancho Cucamonga, CA 917019229
Phone
9097273911
NPI
1295185254
Procedures
2
Total Claims
133
Patients Served
129
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 |
|---|---|---|---|
| Office Visit | $0.00 | 85 | 81 |
| Vaccines & Immunizations | $0.00 | 48 | 48 |
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