Average Medicaid Office Visit Payments in San Juan, PR: $18.99
Avg. Paid
$18.99
Range
$0.00 – $590.91
Total Claims
3,140,039
Providers
1,050
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, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Medical Pharmacy And Lab
Avenida Andglucia 771 Puerto Nuevo |
$1.25 | 476,548 | 370,700 |
|
Centro De Medicina Familiar Del Norte
1551 Calle Alda |
$0.26 | 142,000 | 115,739 |
|
Ldg Medical Services Group, Llc
1225 Ponce De Leon |
$0.74 | 105,278 | 81,837 |
|
Hpm Foundation Inc
2020 Ave Borinquen |
$3.68 | 104,136 | 93,002 |
|
Centro Medicos Unidos Del Oeste
1551 Calle Alda |
$2.85 | 73,888 | 61,675 |
|
Physician Hmo Inc.
107 Calle Padre Las Casas |
$1.05 | 54,264 | 44,141 |
|
Municipality Of San Juan
Bo. Monacillos Centro Medico |
$53.00 | 46,018 | 38,683 |
|
Lba Medical Services Inc
145 Calle Guaraguao |
$4.30 | 39,444 | 33,010 |
|
Menr Medical Services Corp.
1801 Ave Ponce De Leon |
$0.92 | 36,546 | 29,822 |
|
Med Caribe Csp
Urb. Puerto Nuevo |
$1.35 | 28,820 | 23,334 |
|
Juan M Sanchez
262 Ca Ii Convento |
$1.07 | 26,768 | 21,287 |
|
Elaine Jimenez Gonzalez
University District Hospital |
$65.71 | 25,297 | 18,789 |
|
Luis Lebron
40 Calle Capri |
$0.52 | 25,089 | 18,680 |
|
Belinda Rodriguez-Ruiz
743 Calle Acuario |
$0.48 | 24,506 | 21,010 |
|
Luis Alberto Sierra
1479 Ave Ashford Apt 1817 |
$1.70 | 23,405 | 20,673 |
|
Jose L Quintero
12 Calle Siracusa |
$11.05 | 23,145 | 20,454 |
|
Casandra Medina Jimenez
27 Villa Nevarez Cond Los Olmos |
$1.53 | 21,958 | 19,028 |
|
Recinto De Ciencias Medicas
Ave. Americo Miranda Centro Medico De Pr Edif Principal |
$42.55 | 18,482 | 16,408 |
|
Ana Torres
Rr 36 Box 542 |
$1.17 | 16,798 | 13,111 |
|
Physician H.M.O. Inc.
Calle Padre De Las Casa |
$0.29 | 16,792 | 14,616 |
|
L & G Medical Group Inc
405 Calle San Francisco |
$1.07 | 16,497 | 12,183 |
|
Mirtha Sanchez Ovalle
714 Calle Durazno |
$2.06 | 16,485 | 13,178 |
|
Salud 2011, Inc.
32 Calle Mayaguez |
$0.89 | 15,985 | 12,753 |
|
Iris M Cruz Navarro
Center Medical |
$0.10 | 15,184 | 13,164 |
|
Pedro J Palou-Bosch
T3-4 Carr 21 |
$11.40 | 14,804 | 11,836 |
|
Gerardo Javier Tosca
349 Ave. Felisa Rincon De Gautier |
$0.90 | 14,595 | 10,689 |
|
Yudit Maytee Brito Pequera
735 Ave Ponce De Leon |
$2.83 | 14,517 | 12,721 |
|
Maria L Aponte Muniz
Urb Montecarlo |
$0.04 | 14,459 | 9,654 |
|
Susana Schwarz
592 Calle Cesar Gonzalez |
$34.97 | 14,428 | 8,963 |
|
Vivian Lourdes Acebal Lopez
1511Ave. Juan Ponce De Leon |
$81.46 | 13,948 | 11,023 |
|
Michelle J Gomez Cruz
San Juan City Hospital |
$71.98 | 13,684 | 11,723 |
|
Flor Maria Diaz Fontan
Ashford Ave., Cond. Ashford 1000 |
$3.10 | 13,665 | 12,442 |
|
Luis R. Rodriguez
431 Ave Hostos |
$33.00 | 13,345 | 11,413 |
|
Programa Sida De San Juan
1306 Ave Fernandez Juncos |
$24.45 | 13,176 | 9,216 |
|
Gladys Enid Santos Torres
Cond Villas Del Monte 6050 |
$0.09 | 13,174 | 9,270 |
|
Puerto Rico Case Manegement Corp
771 Ave Andalucia |
$8.09 | 12,556 | 11,054 |
|
Luis Torres Vera
508 Ave Hostos |
$48.36 | 12,340 | 10,954 |
|
Eladio Perez Cruz
1449 Calle Americo Salas |
$45.42 | 12,247 | 11,736 |
|
Jose Ramon Flores Caban
735 Ave Ponce De Leon |
$34.04 | 12,233 | 8,164 |
|
Tania Marie Matias
Hospital Municipal De San Juan Centro Medico |
$1.47 | 12,060 | 10,574 |
|
Alianza De Medicos Del Sureste
1551 Calle Alda |
$0.06 | 11,947 | 9,700 |
|
Eduardo Enrique Zaldua
Quintas De Cupey Garden |
$1.91 | 10,888 | 9,541 |
|
Humberto M. Guzman-Perez
1357 Ashford Ave. |
$57.10 | 10,815 | 8,742 |
|
Carmen M Crespo
36 Calle Nevarez |
$0.17 | 10,558 | 9,145 |
|
Glyced Flores-Dejesus
Doctors Medical Pavillion Suite 20 |
$1.55 | 10,487 | 8,471 |
|
Felix David Lugo-Adams
1452 Ave Fernandez Juncos |
$69.60 | 10,160 | 8,584 |
|
Sherry L Santiago-Castro
725 Ave Ponce De Leon Parada 37.5 |
$108.50 | 10,131 | 8,816 |
|
Mariana Cruz Manzano
369 Calle De Diego Torre San Francisco |
$67.85 | 9,807 | 8,560 |
|
Alberto De La Vega
3 Calle San Carlos |
$43.67 | 9,678 | 7,467 |
|
Nayda Betancourt
University Pediatric Hospital |
$0.28 | 9,658 | 7,400 |
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, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in San Juan, PR is $18.99 per claim, based on 3,140,039 claims from 1050 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, PR?
There are 1050 Medicaid providers offering Office Visit related services in San Juan, PR according to public payment data.
What is the price range for Office Visit in San Juan, PR?
Medicaid reimbursement for Office Visit in San Juan, PR ranges from $0.00 to $590.91 per claim, with an average of $18.99. 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 San Juan, PR
Blood Work & Lab Tests
Avg $9.31
1,652,042 claims
Pathology & Lab Services
Avg $77.12
603,331 claims
Dental Cleaning & Exam
Avg $20.92
561,409 claims
X-Ray
Avg $9.69
517,944 claims
Emergency Room Visit
Avg $66.54
406,486 claims
Urinalysis & Urine Tests
Avg $3.33
343,385 claims
Eye Exam
Avg $38.11
328,091 claims
Psychiatric Evaluation
Avg $9.96
280,724 claims