Based on public Medicaid payment data.
Jack Bourklian
Medicaid Provider in Victorville, CA
Type
Individual Provider
Address
15290 Bear Valley Rd
Victorville, CA 923958515
Phone
7609517777
NPI
1801136494
Procedures
4
Total Claims
15.7K
Patients Served
14.9K
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 | $56.40 | 13,508 | 13,474 |
| Dental Filling | $65.35 | 1,396 | 922 |
| Tooth Extraction | $115.25 | 727 | 441 |
| Dental Crown | $476.00 | 39 | 28 |
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