Based on public Medicaid payment data.

Average Medicaid Office Visit Payments in San Juan Capistrano, CA: $22.53

Avg. Paid

$22.53

Range

$0.00 – $100.91

Total Claims

348,117

Providers

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 San Juan Capistrano, CA

Provider	Avg. Paid	Claims	Patients
Sergio Ulises Rodas 30300 Camino Capistrano	$15.75	179,021	151,581
Ashraf Gamil Fahim 27372 Calle Arroyo	$32.91	64,372	51,873
Firozeh Gruber 30300 Camino Capistrano	$17.83	18,971	17,339
San Juan Pediatrics Inc 27372 Calle Arroyo	$40.98	18,749	16,886
Camino Health Center 30300 Camino Capistrano	$19.81	7,982	7,375
Cristina Carolina Romero De Montero 30300 Camino Capistrano	$4.53	7,883	6,328
Thuytrang Diep Nguyen 30300 Camino Capistrano	$19.02	7,686	7,113
William Weiming Chang 30230 Rancho Viejo Rd	$77.85	6,565	5,765
Jennifer Bianca Vincent 31001 Rancho Viejo Rd #200	$0.41	5,707	3,748
Tlc Pediatrics Medical Group 30210 Rancho Viejo Rd	$30.51	5,223	4,667
Lothar Mcmillian 32312 Camino Capistrano	$40.38	5,162	4,421
Mina Abazari 30300 Camino Capistrano	$15.75	4,987	4,756
John H Carruth 30210 Rancho Viejo Rd	$15.99	4,826	3,961
Lizander Cainap Pandy 31001 Rancho Viejo Rd Ste 200	$37.89	3,476	3,142
Audrey Kate Rocco-Welch 30300 Camino Capistrano	$38.66	2,326	2,233
Paloma Medical Group Inc 30230 Rancho Viejo Rd	$25.78	2,166	2,075
Yen-Hui Matthew Soong 30230 Rancho Viejo Rd Ste 200	$35.94	589	587
Kacie Astorga 32332 Camino Capistrano Ste 201	$0.00	503	495
Jay Ashwinbhai Patel 30230 Rancho Viejo Rd Ste 200	$100.91	367	288
Kaveh N Rezvan 30230 Rancho Viejo Rd Ste 200	$58.63	364	341
Charles Martin Strom 33608 Ortega Hwy	$96.59	349	349
Rahul Madhav Kale 30230 Rancho Viejo Rd	$91.13	188	152
Jon Conti 30210 Rancho Viejo Rd Ste A	$9.71	137	136
Hector G Camacho Perez-Arce 27512 Calle Arroyo	$0.22	121	105
Andrew J Hong 31001 Rancho Viejo Rd.	$22.91	102	100
Michael Anthony Rovzar 30230 Rancho Viejo Rd	$65.19	98	77
Jeanne Marie Mcentire 30210 Rancho Viejo Rd	$0.00	78	69
Melissa Ann Stults 30400 Camino Capistrano	$75.08	63	62
Lydia A Chapelsky 30210 Rancho Viejo Rd	$5.42	30	30
Bryan O King 30230 Rancho Viejo Rd	$0.00	14	13
Karen Jean Caruso 30230 Rancho Viejo Rd	$0.00	12	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 San Juan Capistrano, CA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in San Juan Capistrano, CA is $22.53 per claim, based on 348,117 claims from 31 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 San Juan Capistrano, CA?

There are 31 Medicaid providers offering Office Visit related services in San Juan Capistrano, CA according to public payment data.

What is the price range for Office Visit in San Juan Capistrano, CA?

Medicaid reimbursement for Office Visit in San Juan Capistrano, CA ranges from $0.00 to $100.91 per claim, with an average of $22.53. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Office Visit Payments in San Juan Capistrano, CA: $22.53

Providers Offering Office Visit in San Juan Capistrano, CA

What to Expect: Office Visit

Cost Components

Frequently Asked Questions

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