Based on public Medicaid payment data.
Jason Farr Favagehi
Medicaid Provider in Vienna, VA
Type
Individual Provider
Address
8304 Old Courthouse Rd Ste C
Vienna, VA 221823881
Phone
7033561200
NPI
1174764047
Procedures
2
Total Claims
2.2K
Patients Served
2K
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 | $25.21 | 2,130 | 1,944 |
| Dental Filling | $89.18 | 22 | 12 |
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