Average Medicaid Office Visit Payments in Durham, NC: $53.48
Avg. Paid
$53.48
Range
$0.00 – $318.75
Total Claims
1,229,002
Providers
1,194
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 Durham, NC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kwadwo Gyarteng-Dakwa
2609 N Duke St |
$24.67 | 47,735 | 25,479 |
|
Arjumand Bano Syed
3610 N Roxboro St |
$58.47 | 33,777 | 22,431 |
|
Mark C Chandler
3713 University Dr |
$38.10 | 24,669 | 16,357 |
|
Stoney Lee Bowman
4102 Ben Franklin Blvd |
$56.22 | 14,706 | 10,624 |
|
Duke University Health System, Inc.
2301 Erwin Road |
$47.66 | 14,197 | 10,750 |
|
Eileen Margolies Raynor
1000 Trent Dr |
$50.36 | 12,589 | 11,636 |
|
Timothy O'Donnell
1901 Hillandale Rd Ste B |
$15.16 | 12,061 | 10,377 |
|
Daniel Ostrovsky
3116 N Duke St |
$71.91 | 11,518 | 10,544 |
|
Robert Kamiel Lark
Duke University Medical Ctr |
$40.88 | 11,489 | 10,665 |
|
Jeffrey Wellington Scales
6216 Fayetteville Rd |
$59.64 | 10,938 | 9,503 |
|
Nicole Nazon Donnelly
5306 Nc Highway 55 Ste 105 |
$63.82 | 9,983 | 7,410 |
|
Robert Walker Benjamin
4101 N Roxboro St |
$59.54 | 9,925 | 9,220 |
|
Jeffrey Cheng
2301 Erwin Rd |
$66.68 | 9,886 | 9,084 |
|
Belinda Kim Khou
501 Willard St Apt 215 |
$0.14 | 9,621 | 5,254 |
|
Barry Christopher Weed
4102 Ben Franklin Blvd |
$64.65 | 9,243 | 6,812 |
|
Diana Borton Mcshane
5324 Mcfarland Rd |
$69.41 | 9,209 | 8,078 |
|
Valerie Benedicta Idada-Parker
4819 Emperor Blvd # 423 |
$53.22 | 8,362 | 2,691 |
|
Betty M Masten
1301 Fayetteville St |
$78.49 | 8,086 | 6,834 |
|
Kathleen Dolores Rickert-Madden
311 Trent Dr |
$35.29 | 7,703 | 7,517 |
|
Aimee L Ferrandino
1000 Trent Dr |
$39.17 | 7,591 | 6,630 |
|
Nathan Lollins Cheung
2351 Erwin Rd |
$43.36 | 7,471 | 6,077 |
|
Danielle Adriana Dupont Wyant
4111 Ben Franklin Blvd |
$87.71 | 7,390 | 6,597 |
|
Sara Fransen Grace
4102 N Roxboro St |
$56.40 | 7,376 | 5,133 |
|
Lucas Amuchastegui
4205 Ben Franklin Blvd |
$48.18 | 7,325 | 6,978 |
|
John Moses
4020 N Roxboro St |
$81.56 | 7,281 | 6,698 |
|
Nathan Robert Strahl
3326 Durham Chapel Hill Blvd |
$55.22 | 7,278 | 4,665 |
|
Melissa Burleson Micol
2100 Erwin Rd |
$70.10 | 7,242 | 6,189 |
|
Robert Douglas Fitch
4709 Creekstone Dr |
$38.64 | 6,845 | 6,369 |
|
Cindy Damiano
5501 Fortunes Ridge Dr Ste P |
$71.57 | 6,761 | 5,421 |
|
Venus Idette Pitts
2609 N Duke St Ste 403 |
$81.53 | 6,676 | 2,780 |
|
Herbert Fuchs
Duke University Medical Ctr |
$38.34 | 6,436 | 5,992 |
|
Beverly Allen Gray
203 Baker House |
$55.52 | 6,080 | 5,340 |
|
Julie Sage Weber Childers
2301 Erwin Rd |
$76.59 | 6,071 | 5,195 |
|
John Samuel Wiener
Erwin Road |
$46.05 | 6,028 | 5,556 |
|
Sunil Dogra
6216 Fayetteville Rd |
$30.18 | 5,938 | 4,229 |
|
Ashlyn Nicole Gates
5501 Fortunes Ridge Dr Ste P |
$77.26 | 5,778 | 3,912 |
|
Susmitha Joshi
3643 N Roxboro St Fl 6 |
$23.18 | 5,774 | 3,695 |
|
Sharon Freedman
2100 Erwin Rd |
$60.44 | 5,690 | 4,896 |
|
Jenna Lee Hendrickson
1821 Hillandale Rd Ste 24A |
$71.33 | 5,658 | 4,979 |
|
Lisa C Muasher
2101 Erwin Road |
$40.40 | 5,613 | 5,003 |
|
Alex Han Cho
2100 Erwin Rd |
$30.36 | 5,346 | 4,847 |
|
Jacqueline Marie Stewart
3116 N Duke St |
$59.49 | 5,315 | 4,659 |
|
Rebecca Pastelak
2511 Old Cornwallis Rd Ste 200 |
$60.23 | 5,244 | 4,043 |
|
Mark A Pifer
114 Crutchfield St |
$14.07 | 5,226 | 3,446 |
|
Emily Snyder Mccormick
3116 N Duke St |
$81.47 | 5,134 | 4,826 |
|
Mary Sheldon Beckwith
5324 Mcfarland Drive |
$77.40 | 5,122 | 4,713 |
|
Mays Antoine Dairi
4101 N Roxboro St |
$70.17 | 5,078 | 4,202 |
|
Jennifer Lawson
4020 N Roxboro St |
$65.49 | 4,915 | 4,480 |
|
Elizabeth Blyth
7011 Fayetteville Rd Ste 210 |
$72.00 | 4,883 | 4,388 |
|
William F Malcolm
Duke University Medical Ctr |
$47.47 | 4,702 | 4,250 |
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 Durham, NC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Durham, NC is $53.48 per claim, based on 1,229,002 claims from 1194 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 Durham, NC?
There are 1194 Medicaid providers offering Office Visit related services in Durham, NC according to public payment data.
What is the price range for Office Visit in Durham, NC?
Medicaid reimbursement for Office Visit in Durham, NC ranges from $0.00 to $318.75 per claim, with an average of $53.48. 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 Durham, NC
Dental Cleaning & Exam
Avg $29.86
790,132 claims
Substance Abuse Treatment
Avg $122.82
746,211 claims
X-Ray
Avg $5.74
576,677 claims
Blood Work & Lab Tests
Avg $13.80
572,218 claims
Speech Therapy
Avg $57.51
491,949 claims
Psychiatric Evaluation
Avg $65.37
472,359 claims
Emergency Room Visit
Avg $105.90
448,598 claims
Vaccines & Immunizations
Avg $15.02
377,320 claims