Average Medicaid Office Visit Payments in Derby, NY: $61.79
Avg. Paid
$61.79
Range
$15.67 – $104.08
Total Claims
67,021
Providers
21
Typical Payment Range
Typical Medicaid Office Visit payments fall between $29.28 and $67.92 per claim (median: $46.55). The top 10% of payments exceed $95.29.
Based on per-provider averages across all Medicaid claims in this category.
A standard doctor's office visit for evaluation and management of medical conditions. Includes new patient visits, follow-up visits, and consultations.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Office Visit in Derby, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
John M Mulawka
6763 Erie Road Rt 5 |
$60.56 | 26,941 | 24,821 |
|
Betsy L Strack
6763 Erie Rd |
$46.79 | 10,704 | 9,943 |
|
Tariq A Sheikh
7060 Erie Rd |
$58.95 | 7,747 | 7,031 |
|
Harmonia Collaborative Care Inc
6722 Erie Rd |
$101.26 | 6,107 | 5,795 |
|
Douglas D Hage
7020 Erie Rd |
$69.11 | 5,523 | 5,413 |
|
Angel M Szkutak
7060 Erie Rd |
$51.19 | 3,047 | 2,809 |
|
Eric Dibben
7060 Erie Rd |
$66.83 | 2,060 | 2,046 |
|
Peter Samuel Mcquiller
6970 Erie Rd |
$58.26 | 1,431 | 1,349 |
|
Debra Sue Longbine
6970 Erie Rd |
$34.57 | 887 | 847 |
|
Sandra Chandia
6763 Erie Rd |
$57.81 | 684 | 649 |
|
Debbie Opoku
7060 Erie Rd |
$62.33 | 371 | 346 |
|
Anjana Hemraj Porwal
6970 Erie Rd Ste A |
$46.93 | 304 | 279 |
|
Morris M Cavalieri
7020 Erie Rd |
$55.94 | 259 | 232 |
|
Lena R Baxter
6722 Erie Rd |
$50.93 | 230 | 216 |
|
Miranda Ring
7060 Erie Rd |
$15.67 | 226 | 203 |
|
Brooks - Tlc Hospital System, Inc.
7020 Erie Road |
$104.08 | 198 | 168 |
|
Beth Ann Weslow
6970 Erie Rd |
$50.54 | 127 | 119 |
|
Henna M Patel
7060 Erie Rd Suite 100 |
$60.22 | 72 | 65 |
|
Dakota Rose Coles
7020 Erie Rd |
$65.28 | 65 | 65 |
|
Kristine Ingro
6722 Erie Rd |
$67.64 | 25 | 25 |
|
Jessica Lynn Hargarther
1437 Independence Dr |
$30.46 | 13 | 12 |
What to Expect: Office Visit
A typical office visit lasts 15-45 minutes depending on complexity. Your doctor will review your medical history, discuss symptoms, perform a physical exam, and discuss treatment options. You may receive prescriptions, referrals, or orders for diagnostic tests. Follow-up visits are usually shorter than new patient visits.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 99213 | Office visit established mod | $43.18 | 764,306,590 | 487,602 |
| 99214 | Office visit established mod-hi | $59.53 | 502,480,931 | 466,856 |
| 99212 | Office visit established low | $41.69 | 92,299,154 | 127,462 |
| 99203 | Office visit new moderate | $67.55 | 47,756,882 | 127,334 |
| 99211 | Office visit established minor | $39.24 | 44,127,221 | 47,748 |
| 99204 | Office visit new moderate-high | $92.03 | 32,379,031 | 111,937 |
| 99215 | Office visit established high | $93.58 | 29,619,773 | 74,725 |
| 99202 | Office visit new low | $58.57 | 9,372,712 | 35,486 |
| 99205 | Office visit new high | $136.10 | 3,665,382 | 19,737 |
| 99244 | Office consultation mod-high | $118.25 | 3,405,681 | 11,884 |
| 99243 | Office consultation moderate | $78.55 | 2,585,480 | 8,432 |
| 99245 | Office consultation high | $132.29 | 645,300 | 3,046 |
| 99242 | Office consultation low | $58.27 | 483,445 | 1,980 |
| 99241 | Office consultation brief | $66.15 | 295,664 | 712 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Office Visit cost in Derby, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Derby, NY is $61.79 per claim, based on 67,021 claims from 21 providers. Typical payments fall between $29.28 and $67.92. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Office Visit in Derby, NY?
There are 21 Medicaid providers offering Office Visit related services in Derby, NY according to public payment data.
What is the price range for Office Visit in Derby, NY?
Medicaid reimbursement for Office Visit in Derby, NY ranges from $15.67 to $104.08 per claim, with an average of $61.79. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Office Visit in Other Cities
Brooklyn, NY
Avg $71.20
32,336,840 claims · 5588 providers
New York, NY
Avg $81.86
23,551,154 claims · 7530 providers
Los Angeles, CA
Avg $24.20
16,948,065 claims · 5565 providers
Chicago, IL
Avg $30.31
13,989,780 claims · 5801 providers
Bronx, NY
Avg $82.40
13,626,712 claims · 3705 providers
Phoenix, AZ
Avg $47.53
13,269,420 claims · 4233 providers
Houston, TX
Avg $48.27
8,766,644 claims · 4540 providers
Las Vegas, NV
Avg $54.47
8,578,324 claims · 3512 providers
Other Procedures in Derby, NY
Psychiatric Evaluation
Avg $108.13
26,957 claims
Vaccines & Immunizations
Avg $14.15
22,706 claims
Urinalysis & Urine Tests
Avg $2.64
2,604 claims
Prescription Medications
Avg $78.60
1,722 claims
Speech Therapy
Avg $83.63
1,244 claims
Ultrasound
Avg $95.28
711 claims
Eye Exam
Avg $49.49
576 claims
Blood Work & Lab Tests
Avg $1.46
201 claims