Based on public Medicaid payment data.
Lee Lo
Medicaid Provider in Sacramento, CA
Type
Individual Provider
Address
4561 Mack Rd
Sacramento, CA 95823
Phone
9164222171
NPI
1992213623
Procedures
3
Total Claims
3.1K
Patients Served
2.9K
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 | $31.17 | 2,551 | 2,548 |
| Dental Filling | $19.96 | 489 | 311 |
| Tooth Extraction | $29.13 | 94 | 50 |
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