Average Medicaid Office Visit Payments in Wilkes-Barre, PA: $47.07
Avg. Paid
$47.07
Range
$0.00 – $70.22
Total Claims
7,088
Providers
13
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 Wilkes-Barre, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Glen C Jacob
1175 East Mountain Blvd. |
$44.19 | 3,204 | 3,068 |
|
Abdul Mutalib Adjei
1000 East Mountain Blvd. |
$44.43 | 1,117 | 1,076 |
|
Kenny Alan A Schwartz
1000 East Mountain Blvd. |
$63.37 | 1,045 | 1,036 |
|
Maya Lillyan Lichtenstein
1000 East Mountain Blvd. |
$56.10 | 467 | 451 |
|
Thomas Andrew Erchinger
1000 East Mountain Blvd. |
$41.99 | 294 | 286 |
|
Jacqueline Clare Oxenberg
1000 East Mountain Blvd. |
$44.33 | 232 | 223 |
|
Larisa Alexeyevna Yarczower
1000 E. Mountain Drive |
$62.01 | 174 | 170 |
|
Raniah Sherif Khairy
1155 East Mountain Blvd. |
$1.80 | 136 | 130 |
|
Charles David Peters
1000 East Mountain Blvd. |
$41.20 | 131 | 128 |
|
Bogdan Protyniak
1000 East Mountain Blvd |
$70.22 | 117 | 115 |
|
Jamie Wade
84 W South Street |
$12.61 | 68 | 50 |
|
Boyoung Song
1000 East Mountain Blvd. |
$35.75 | 52 | 51 |
|
Rural Health Corporation Of Northeastern Pennsylvania
276 East End Centre |
$0.00 | 51 | 38 |
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 Wilkes-Barre, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Wilkes-Barre, PA is $47.07 per claim, based on 7,088 claims from 13 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 Wilkes-Barre, PA?
There are 13 Medicaid providers offering Office Visit related services in Wilkes-Barre, PA according to public payment data.
What is the price range for Office Visit in Wilkes-Barre, PA?
Medicaid reimbursement for Office Visit in Wilkes-Barre, PA ranges from $0.00 to $70.22 per claim, with an average of $47.07. 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 Wilkes-Barre, PA
Home Health Visit
Avg $237.15
41,813 claims
Emergency Room Visit
Avg $81.37
14,819 claims
EKG / ECG (Electrocardiogram)
Avg $6.39
12,010 claims
Blood Work & Lab Tests
Avg $6.18
9,917 claims
X-Ray
Avg $8.42
7,788 claims
CT Scan (Computed Tomography)
Avg $51.42
3,562 claims
Nursing Facility Care
Avg $13.12
1,636 claims
Echocardiogram
Avg $43.86
1,592 claims