Based on public Medicaid payment data.
Tracy Ku
Medicaid Provider in San Gabriel, CA
Type
Individual Provider
Address
1448 S San Gabriel Blvd
San Gabriel, CA 917763656
Phone
6262882000
NPI
1740398353
Procedures
3
Total Claims
3.9K
Patients Served
3.8K
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 | $66.13 | 3,621 | 3,598 |
| Dental Filling | $59.97 | 280 | 159 |
| Tooth Extraction | $119.00 | 17 | 12 |
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