Average Medicaid Office Visit Payments in Toa Alta, PR: $5.13
Avg. Paid
$5.13
Range
$0.00 – $94.71
Total Claims
104,269
Providers
25
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 Toa Alta, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Benjamin Gonzalez
Urb. Masiones De Monte Casino I |
$1.40 | 19,418 | 15,100 |
|
Orlando Fonseca Martinez
204 Calle 5 |
$0.10 | 14,324 | 10,245 |
|
Pedro Juan Diaz Martinez
87 Street Jose' Dediego |
$0.04 | 11,551 | 8,687 |
|
Juan Cecilio Echeandia
Avenidad Principal Toa Alta Height N-13 |
$0.10 | 10,038 | 7,348 |
|
Itza Doris Chevres
Calle 10 Carr.165 Esq. G-21 Urb. Villa Matilde |
$4.13 | 9,331 | 8,115 |
|
Sandra I Rosado Medina
Carr 861 |
$0.39 | 7,078 | 5,331 |
|
Linnette Rosado Medina
Carr 861 |
$0.36 | 5,385 | 4,427 |
|
Victor M Vazquez-Moreno
3211 Calle Rio Guayabo |
$6.98 | 5,182 | 5,134 |
|
Lourdes M Del Campo
# 261 Urb. Ciudad Jardin |
$1.01 | 4,505 | 3,859 |
|
Jose Angel Jimenez
Jardines De Toa Alta Calle 1 #55 |
$0.00 | 3,626 | 2,655 |
|
Odrick Roberto Rosas
Calle 1, A1 Urb San Fernando |
$94.71 | 3,074 | 2,760 |
|
Ana Yanira Garcia Marrero
46 Calle 4 |
$37.21 | 2,695 | 2,350 |
|
Emerito Ventura
G21 Calle 10 |
$0.61 | 2,174 | 1,884 |
|
Ilsa Janice Nazario
436 Calle Culebrinas # Q8 |
$1.51 | 1,640 | 1,369 |
|
Salud Integral En La Montana, Inc.
Carr. 165 Km 4.5 |
$12.21 | 1,214 | 1,054 |
|
Family Health Clinic Of Caribbean, Inc
G 21 Calle 10 |
$6.53 | 918 | 782 |
|
Eduardo Alfonso Rios
32 Antonio Lopez |
$0.00 | 844 | 506 |
|
Carlos E Perez Semidei
Calle 1 Villa Amparo |
$0.00 | 749 | 553 |
|
Ana M Rodriguez Santiago
Rio Del Plata Mall |
$0.00 | 334 | 205 |
|
Policlinica La Familia Toa Alta, Inc.
10St #G-21, Urb. Villa Matilde |
$1.37 | 60 | 53 |
|
Jorge Luis Sifre
83 Calle Roble |
$86.42 | 51 | 38 |
|
Waxali Inc
Rio Del Plata Mall,Urb Jardines De Toa Alta,Calle # 1 |
$0.00 | 28 | 26 |
|
Nydia M Lopez Diaz
Carr. 828 Km. 0.1 |
$0.00 | 19 | 17 |
|
Jose Cumba Guerrero
Palacios Del Rio Ii |
$0.00 | 18 | 12 |
|
Salud Integral En La Montana, Inc.
Calle Jose De Diego |
$57.10 | 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 Toa Alta, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Toa Alta, PR is $5.13 per claim, based on 104,269 claims from 25 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 Toa Alta, PR?
There are 25 Medicaid providers offering Office Visit related services in Toa Alta, PR according to public payment data.
What is the price range for Office Visit in Toa Alta, PR?
Medicaid reimbursement for Office Visit in Toa Alta, PR ranges from $0.00 to $94.71 per claim, with an average of $5.13. 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 Toa Alta, PR
Blood Work & Lab Tests
Avg $10.97
264,289 claims
Dental Cleaning & Exam
Avg $20.41
106,198 claims
Urinalysis & Urine Tests
Avg $3.96
68,374 claims
Physical Therapy
Avg $21.99
38,500 claims
Vaccines & Immunizations
Avg $9.40
26,529 claims
Dental Filling
Avg $39.50
19,744 claims
Eye Exam
Avg $53.62
12,523 claims
Psychiatric Evaluation
Avg $2.39
9,070 claims