Based on public Medicaid payment data.
Jeremy Ryan Vistica
Medicaid Provider in Huntington Beach, CA
Type
Individual Provider
Address
5512 Maryport Dr
Huntington Beach, CA 926494821
Phone
5037065944
NPI
1639368582
Procedures
2
Total Claims
986
Patients Served
891
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 | $358.22 | 970 | 877 |
| Dental Filling | $404.50 | 16 | 14 |
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