Based on public Medicaid payment data.
Matthew Listiyo
Medicaid Provider in Ontario, CA
Type
Individual Provider
Address
1361 E 4Th St
Ontario, CA 917643035
Phone
9164203989
NPI
1104472778
Procedures
2
Total Claims
691
Patients Served
556
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 | $69.74 | 448 | 448 |
| Dental Filling | $62.22 | 243 | 108 |
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