Based on public Medicaid payment data.
Jason Song
Medicaid Provider in San Jose, CA
Type
Individual Provider
Address
1628 Hostetter Rd Ste J
San Jose, CA 951313309
Phone
4089299999
NPI
1538610142
Procedures
3
Total Claims
312
Patients Served
271
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 | $5.40 | 156 | 156 |
| Dental Filling | $22.04 | 135 | 101 |
| Tooth Extraction | $26.67 | 21 | 14 |
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