Average Medicaid Office Visit Payments in Toa Baja, PR: $3.02
Avg. Paid
$3.02
Range
$0.00 – $72.31
Total Claims
201,766
Providers
52
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 Baja, PR
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Yanira Medina Claudio
Hf16 Calle Lizzie Graham |
$0.71 | 15,229 | 12,907 |
|
Juan M Roman
Ave Sabana Seca Carr 867 Km 2.2 |
$0.70 | 14,572 | 12,610 |
|
Denise Rosario Camacho Rodriguez
Calle Doctor Estevan De Rosa #Bw6 |
$0.32 | 12,375 | 10,404 |
|
Magaly Santiago
Elisa Tavarez Hc 17 |
$0.29 | 10,906 | 9,634 |
|
Carlos H Viana Reyes
Hf16 Calle Lizzie Graham |
$2.92 | 9,784 | 8,286 |
|
Jorge Cedeno Espaillat
610 Ave. Comerio Final |
$0.74 | 8,869 | 7,852 |
|
Nabil Salah Aldin
Carr.863 Km.0.6 |
$0.04 | 8,782 | 6,517 |
|
Sandra Violeta Soto
77 Calle Bruno Cruz |
$2.29 | 8,302 | 7,274 |
|
Marielys Girona Lozada
Hf16 Calle Lizzie Graham |
$1.22 | 8,212 | 6,890 |
|
Pedro L. Ramos
Rd. 867 Km 5.0 #183 |
$0.31 | 8,053 | 5,289 |
|
Jose A Garcia Lugo
Ea06 Calle Rosa De Tejas |
$1.32 | 7,543 | 5,739 |
|
Servanda C Fleitas Macias
Hf16 Calle Lizzie Graham |
$0.39 | 7,390 | 5,402 |
|
Ana Margarita Soto
Paseo Cipres # 3097 Levittown |
$0.73 | 6,876 | 5,998 |
|
Cesar Viana
Km1.5 Calle 863 |
$0.43 | 6,505 | 5,735 |
|
William Grassette Melendez
3474 Paseo Camaron |
$1.21 | 5,783 | 4,945 |
|
Centro De Cuidados Dirigidos De Levittown Inc
Hf16 Calle Lizzie Graham |
$1.27 | 5,584 | 4,942 |
|
Glorimar Rivera Rivera
Ev1 Calle Salvador Brau |
$0.00 | 5,234 | 3,068 |
|
Mariely Agosto
He10 Avenue Amalia Paoli |
$1.10 | 4,540 | 3,533 |
|
Carla Michelle Hernandez Mercado
Camino De La Zarzuela Sf-22 Mansion Sur |
$9.93 | 4,390 | 3,634 |
|
Maria Enid Baez Colon
Urb. La Mansion Camino De Velarde Nf-16 |
$1.90 | 4,214 | 4,115 |
|
Morovis Community Health Center, Inc.
Pr-863 Km 1.0 Sector Pajaros |
$4.88 | 4,076 | 3,457 |
|
Luis A Paris Rivera
Hf16 Calle Lizzie Graham |
$1.16 | 3,837 | 3,154 |
|
Ivonne Padilla Aquino
Hf16 Calle Lizzie Graham |
$4.14 | 3,833 | 3,458 |
|
Yolanda Sierra Quinones
Y35 Blvd Monroig |
$0.78 | 3,642 | 3,133 |
|
Evelyn Padilla Lopez
3175 Del Valle Ave |
$0.22 | 3,138 | 2,864 |
|
Jose Angel Quinones
J22 Suite 4 Calle Myrna |
$3.16 | 2,430 | 1,852 |
|
Rafael Gandia
Ak12 Calle 8 |
$0.00 | 2,341 | 1,828 |
|
Yairamaris Pelet Giraud
Hf16 Lizzie Granham |
$72.31 | 2,234 | 1,685 |
|
Efrain Fernando Ortiz Diaz
Camino Del Mar Via Caracol St. #2020 |
$0.11 | 1,535 | 1,445 |
|
Rodolfo Orozco
G24 Calle Magda E |
$2.69 | 1,511 | 1,297 |
|
Maria De Lourdes Miranda
Aa3 Ave Don Pelayo |
$11.68 | 1,256 | 900 |
|
Michelle Lozada Martinez
Suite G Davison Plaza, Comerio Ave |
$0.00 | 1,209 | 760 |
|
Metro Toa Baja, Inc.
Ave Sabana Seca Int 867 |
$49.07 | 1,129 | 1,071 |
|
Ezequiel Lafontaine
Barrio Ingenio Ii 180 |
$0.01 | 1,057 | 862 |
|
Jose Emilio Ortiz Betancourt
Hf16 Calle Lizzie Graham |
$0.00 | 1,024 | 531 |
|
Veronica Alana Vestal
7056 Via Playera |
$47.66 | 771 | 485 |
|
Metro Toa Baja Inc.
Ave Sabana Seca |
$50.74 | 690 | 675 |
|
Carlos A Buxo Tirado
Y38 Boulevard Monroig |
$59.19 | 607 | 557 |
|
David Rafael Perez Pantoja
Fp39 Calle Mariano Brau |
$0.13 | 603 | 547 |
|
Jose Luis Garcia
1C 13 Don Pelayo Ave. |
$0.00 | 319 | 314 |
|
Jose E Vazquez Colon
Hf16 Calle Lizzie Graham |
$59.40 | 318 | 284 |
|
Carlos Alberto Santiago Sanchez
1000 Ave Dos Palmas |
$8.44 | 238 | 191 |
|
Ayeisha Escartin
Ave. Comerio 610 (Marginal) |
$0.00 | 171 | 161 |
|
Iris M Aranzamendi
Hf16 Calle Lizzie Graham |
$0.82 | 131 | 128 |
|
Luis Angel Diaz Cruz
A La Orden Shopping Center 2Nd Fl 600 |
$15.62 | 127 | 125 |
|
Grace Rullan
Jr5 Calle Lizzie Graham |
$1.33 | 120 | 96 |
|
Rafael Soto
Ave. Boulevard # 3326 |
$4.71 | 97 | 75 |
|
Airin A Morales
Ave Pos Palmos 2765 Edif O Ficentro |
$39.97 | 69 | 69 |
|
Vivian Ivette Acevedo
Ave Boulevard #2509 |
$38.24 | 37 | 37 |
|
Angel F. Delgado Garrastegui
A La Orden Shopping Center Ave Comerio Norte |
$6.01 | 29 | 29 |
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 Baja, PR?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Toa Baja, PR is $3.02 per claim, based on 201,766 claims from 52 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 Baja, PR?
There are 52 Medicaid providers offering Office Visit related services in Toa Baja, PR according to public payment data.
What is the price range for Office Visit in Toa Baja, PR?
Medicaid reimbursement for Office Visit in Toa Baja, PR ranges from $0.00 to $72.31 per claim, with an average of $3.02. 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 Baja, PR
Blood Work & Lab Tests
Avg $9.31
326,030 claims
Dental Cleaning & Exam
Avg $21.01
78,156 claims
Urinalysis & Urine Tests
Avg $3.17
72,774 claims
Durable Medical Equipment (DME)
Avg $34.40
68,403 claims
Vaccines & Immunizations
Avg $4.91
28,018 claims
Psychiatric Evaluation
Avg $2.39
25,537 claims
Speech Therapy
Avg $47.52
19,784 claims
Dental Filling
Avg $49.94
12,020 claims