Based on public Medicaid payment data.
Lidya Khalil
Medicaid Provider in Rancho Cucamonga, CA
Type
Individual Provider
Address
11687 Mount Waverly Ct
Rancho Cucamonga, CA 917377904
Phone
5623758441
NPI
1982218947
Procedures
4
Total Claims
813
Patients Served
673
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 | $65.20 | 534 | 526 |
| Tooth Extraction | $118.37 | 190 | 76 |
| Dental Filling | $67.20 | 47 | 39 |
| Dental Crown | $476.00 | 42 | 32 |
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