Average Medicaid Office Visit Payments in Dover, DE: $55.49
Avg. Paid
$55.49
Range
$0.00 – $180.46
Total Claims
541,196
Providers
252
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 Dover, DE
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Bayhealth Medical Center, Inc
640 S State St |
$57.39 | 97,072 | 71,934 |
|
Dedicated To Women Ob-Gyn, P.A.
200 Banning St |
$73.19 | 48,678 | 31,246 |
|
Cnmri
1095 S Bradford St |
$54.80 | 27,681 | 22,312 |
|
Abc Pediatrics Llc
740 S New St |
$61.74 | 21,988 | 18,527 |
|
Kids And Teens Pediatrics Of Dover
125 Greentree Dr Ste 1 |
$55.15 | 17,667 | 14,138 |
|
Camden Walk-In Llc
4601 S Dupont Hwy |
$60.96 | 15,906 | 11,757 |
|
A Center For Mental Wellness, Inc.
121 W Loockerman St |
$61.43 | 15,737 | 13,105 |
|
The Mind And Body Consortium, Llc.
156 S State St |
$63.54 | 14,155 | 11,923 |
|
Delaware Eye Care Center Pa
833 S Governors Ave |
$58.44 | 13,950 | 11,833 |
|
Savida Health, Pc
938 S Bradford St |
$84.38 | 10,958 | 7,319 |
|
Bright Future Pediatrics, Llc
938 S Bradford St |
$68.17 | 8,048 | 7,031 |
|
Sitta Baby Gombeh-Alie
640 S Queen St |
$109.09 | 7,896 | 7,416 |
|
Bayhealth Medical Center, Inc.
640 South State Street |
$50.12 | 7,728 | 5,314 |
|
Kent Pulmonary Associates
938 S Bradford St |
$63.88 | 7,659 | 6,814 |
|
State Of Delaware
417 Federal St |
$36.46 | 7,448 | 6,208 |
|
Delaware Primary Care Llc
810 New Burton Rd |
$69.12 | 7,252 | 6,555 |
|
Camden Primary Care L.L.C.
4601 S Dupont Hwy |
$70.23 | 6,953 | 5,599 |
|
Bayhealth Medical Center, Inc
1074 S State St |
$67.01 | 6,885 | 5,193 |
|
Delaware Podiatric Medicine Pa
22 Old Rudnick Ln |
$36.52 | 6,868 | 5,815 |
|
Dover Family Physicians Pa
1342 S Governors Ave |
$69.35 | 6,433 | 5,385 |
|
Primary Care Of Delaware,Llc
1001 S Bradford St |
$48.95 | 6,128 | 5,267 |
|
Rheumatology Center Of Delaware, Llc
260 Beiser Blvd Ste 201 |
$71.97 | 6,030 | 5,548 |
|
Patricia Powell
200 Banning St Ste 210 |
$109.56 | 5,843 | 3,645 |
|
Mental Edge Counseling, Llc
1198 S Governors Ave Ste 201 |
$54.47 | 5,669 | 4,757 |
|
Urology Associates Of Delaware P.A.
200 Banning St |
$54.04 | 5,336 | 4,196 |
|
Kent Pediatrics, Llc
1102 S Dupont Hwy |
$68.88 | 4,629 | 3,918 |
|
Eranga Cardiology, Pa
200 Banning St Ste 310 |
$64.92 | 4,484 | 3,887 |
|
Halpern Medical Services Llc
200 Banning St |
$56.48 | 4,352 | 3,317 |
|
Southside Family Practice, P.A.
230 Beiser Blvd |
$67.18 | 4,295 | 3,869 |
|
Richa Sharma
18 Old Rudnick Ln |
$64.73 | 4,024 | 3,813 |
|
Kaza Medical Group
18 Old Rudnick Ln |
$65.91 | 3,884 | 3,454 |
|
Governors Family Practice P.A
1177A S Governors Ave |
$54.61 | 3,831 | 2,870 |
|
Abdul Muhaymin Siyal
720 S Queen St |
$47.32 | 3,405 | 1,523 |
|
Gunit Kaur Kahlon
103 Mont Blanc Blvd. |
$59.16 | 3,154 | 3,059 |
|
A Peaceful Place Integrated Care
1001 S Bradford St Ste 7 |
$77.01 | 3,101 | 2,611 |
|
Family Allergy & Asthma Care Consultants Llc
103 Wolf Creek Blvd Ste 1 |
$66.09 | 3,094 | 2,756 |
|
Bayhealth Medical Center, Inc
640 S State St |
$56.16 | 3,002 | 2,638 |
|
Regional Medical Associates, Pa
240 Beiser Blvd |
$74.62 | 2,900 | 2,230 |
|
Nasreen Khan
1113 S State St |
$2.35 | 2,459 | 1,761 |
|
Fizul Hussain Bacchus
863 Buttner Place |
$0.74 | 2,442 | 1,941 |
|
Thuya Aye
1025 S Governors Ave |
$4.63 | 2,363 | 1,470 |
|
Vineet Puri
1001 S Bradford St |
$6.53 | 2,228 | 1,704 |
|
Harry S Tam
22 Old Rudnick Ln |
$28.06 | 2,138 | 1,914 |
|
Mamoon Mahmoud
740 S New St |
$0.85 | 2,051 | 1,809 |
|
Infusion Solutions Of Delaware
1100 Forrest Ave |
$63.43 | 1,982 | 1,860 |
|
Tamesis Rheumatology Medicine Of Delaware, P.A
1673 S State St |
$55.70 | 1,872 | 1,460 |
|
Central Delaware Family Medicine
1001 S Bradford St |
$58.69 | 1,839 | 1,677 |
|
First State Oral And Maxillofacial Surgery Corp
1004 S State St Ste 1 |
$71.16 | 1,820 | 1,787 |
|
Jack R Milligan
766 S State St |
$1.13 | 1,799 | 1,040 |
|
Gail Marie Kelly
102 W. Water Street, Suite 1 |
$124.10 | 1,739 | 1,631 |
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 Dover, DE?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Dover, DE is $55.49 per claim, based on 541,196 claims from 252 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 Dover, DE?
There are 252 Medicaid providers offering Office Visit related services in Dover, DE according to public payment data.
What is the price range for Office Visit in Dover, DE?
Medicaid reimbursement for Office Visit in Dover, DE ranges from $0.00 to $180.46 per claim, with an average of $55.49. 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 Dover, DE
Personal Care Services
Avg $107.16
437,262 claims
Blood Work & Lab Tests
Avg $14.59
230,179 claims
Emergency Room Visit
Avg $142.47
220,056 claims
X-Ray
Avg $11.25
131,691 claims
Psychiatric Evaluation
Avg $55.09
118,201 claims
Dental Cleaning & Exam
Avg $50.03
102,368 claims
Vaccines & Immunizations
Avg $7.81
91,997 claims
Ultrasound
Avg $41.46
77,650 claims