Based on public Medicaid payment data.
Soodong Kim
Medicaid Provider in San Bernardino, CA
Type
Individual Provider
Address
1728 N D St
San Bernardino, CA 924054418
Phone
9098860087
NPI
1689720740
Procedures
4
Total Claims
16K
Patients Served
13.9K
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 | $48.49 | 10,947 | 10,942 |
| Dental Filling | $64.37 | 4,156 | 2,331 |
| Tooth Extraction | $57.05 | 812 | 512 |
| Dental Crown | $476.00 | 119 | 76 |
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