Based on public Medicaid payment data.
Mary Boots Fiesta Robinos
Medicaid Provider in San Jose, CA
Type
Individual Provider
Address
2664 Berryessa Rd
San Jose, CA 951322925
Phone
5103649619
NPI
1205006707
Procedures
2
Total Claims
350
Patients Served
251
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 Filling | $67.37 | 218 | 119 |
| Dental Cleaning & Exam | $71.38 | 132 | 132 |
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