Average Medicaid Office Visit Payments in Upper Darby, PA: $30.81
Avg. Paid
$30.81
Range
$0.00 – $68.24
Total Claims
26,917
Providers
21
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 Upper Darby, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Dana Heller
5 S State Rd |
$0.00 | 15 | 15 |
|
Fengzhi Liu
6787 Market St |
$4.46 | 29 | 26 |
|
Eunice Eunjin Sun
6787 Market St Ste 101 |
$62.20 | 34 | 33 |
|
Kyle Shaw
8011 W Chester Pike |
$5.40 | 34 | 26 |
|
Sonal Patel
1560 Garrett Rd Ste F |
$21.58 | 36 | 33 |
|
Holcomb Associates, Inc.
225 S 69Th St |
$43.11 | 67 | 64 |
|
Windell Henry Anthony Murphy
6800 Market St |
$68.24 | 70 | 70 |
|
Nestor Biletsky
1560 Garrett Rd Ste F |
$44.67 | 74 | 71 |
|
Obot Grace Tigah
7200 Chestnut St |
$18.32 | 96 | 94 |
|
Ellie Z. Zheng
6787 Market St |
$20.11 | 174 | 161 |
|
Godson Asamoa
7408 W Chester Pike |
$52.24 | 189 | 185 |
|
Everest Urgent Care
6787 Market St |
$29.88 | 283 | 191 |
|
Bernadette Lloyd-Sobolow
1560 Garrett Rd |
$65.36 | 345 | 313 |
|
Saurin Patel
1560 Garrett Rd Ste F |
$44.87 | 603 | 570 |
|
Nichole P Turner
120 Summit Ave |
$11.62 | 1,004 | 990 |
|
Alan Scott Groth
708 Long Ln |
$34.77 | 1,766 | 1,679 |
|
Omana George Abraham
8234 W Chester Pike |
$31.26 | 2,013 | 1,888 |
|
Nghia T. Phan
6800 Market St |
$8.62 | 2,575 | 2,455 |
|
Patricia A Ragone
1560 Garrett Rd |
$51.74 | 2,732 | 2,170 |
|
Ronald Lee Smith
7125 Hilltop Rd |
$1.81 | 3,596 | 3,454 |
|
Khanh Che
7140 Chestnut Street |
$38.97 | 11,182 | 9,240 |
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 Upper Darby, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Upper Darby, PA is $30.81 per claim, based on 26,917 claims from 21 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 Upper Darby, PA?
There are 21 Medicaid providers offering Office Visit related services in Upper Darby, PA according to public payment data.
What is the price range for Office Visit in Upper Darby, PA?
Medicaid reimbursement for Office Visit in Upper Darby, PA ranges from $0.00 to $68.24 per claim, with an average of $30.81. 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
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Houston, TX
Avg $48.27
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Las Vegas, NV
Avg $54.47
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Other Procedures in Upper Darby, PA
Case Management Services
Avg $75.36
52,396 claims
Eye Exam
Avg $33.99
23,560 claims
Psychiatric Evaluation
Avg $57.68
3,909 claims
Dental Cleaning & Exam
Avg $25.88
3,713 claims
Dialysis
Avg $15.34
3,298 claims
Podiatry (Foot Care)
Avg $0.40
1,730 claims
Durable Medical Equipment (DME)
Avg $12.59
1,453 claims
Physical Therapy
Avg $17.09
1,088 claims