Average Medicaid Office Visit Payments in Wilmington, DE: $55.68
Avg. Paid
$55.68
Range
$0.00 – $262.09
Total Claims
1,174,146
Providers
633
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 Wilmington, DE
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
The Nemours Foundation
1600 Rockland Rd |
$93.32 | 273,610 | 227,773 |
|
Westside Family Healthcare, Inc.
1802 W 4Th St |
$0.05 | 62,715 | 46,984 |
|
Christiana Care Health Services Inc
501 W 14Th St |
$49.97 | 56,142 | 38,604 |
|
Medexpress, Inc - Delaware
2722 Concord Pike |
$66.27 | 31,389 | 27,055 |
|
Delaware Cardiovascular Associates, P.A.
1403 Foulk Rd |
$52.11 | 20,722 | 17,295 |
|
Precision Care & Wellness, Llc
4001 Miller Rd Ste 1 |
$49.76 | 19,914 | 15,616 |
|
Regional Orthopaedic Associates, Pa
1941 Limestone Rd Ste 101 |
$79.68 | 19,114 | 16,439 |
|
Christiana Care Health Services, Inc
501 W 14Th St |
$26.75 | 19,092 | 12,913 |
|
St. Francis Hospital Inc.
701 N Clayton St 2Nd Fl. |
$57.72 | 17,954 | 13,726 |
|
Seth L Ivins Md Llc
2601 Annand Dr |
$65.85 | 16,638 | 14,439 |
|
Brandywine Counseling & Community Services, Inc.
2713 Lancaster Ave |
$69.67 | 15,704 | 12,785 |
|
Brandywine Podiatry, Pa
1010 North Bancroft Parkway |
$57.53 | 13,040 | 11,505 |
|
Total Care Physicians, P.A.
405 Silverside Rd Ste 111 |
$65.12 | 12,840 | 10,675 |
|
First State Medical Associates
2055 Limestone Rd |
$50.85 | 11,331 | 9,467 |
|
Thomas E Stephens
1802 W 4Th St |
$0.00 | 11,202 | 9,066 |
|
Brandywine Medical Associates, Inc.
1815 W 13Th St |
$57.22 | 11,179 | 9,015 |
|
James Francis Bonner
206 N Union St |
$26.93 | 11,000 | 9,881 |
|
Christiana Care Health Services, Inc
1401 Foulk Rd |
$48.93 | 10,907 | 7,491 |
|
Family Practice Associates, Pa
1100 S Broom St |
$55.05 | 10,702 | 8,855 |
|
Francis Mase M.D., P.A.
700 W Lea Blvd |
$69.97 | 10,186 | 8,754 |
|
Family Medicine At Greenhill
213 Greenhill Ave Ste B |
$65.29 | 9,996 | 8,304 |
|
Med Psych Services Llc
5163 W Woodmill Dr Ste 13 |
$70.36 | 9,600 | 5,070 |
|
Christiana Care Health Services Inc
501 W 14Th St Fl 6 |
$33.34 | 9,307 | 6,299 |
|
Christiana Care Health Services Inc
3506 Kennett Pike |
$54.69 | 9,118 | 6,763 |
|
Trinity Medical Associates Pa
410 Foulk Rd |
$74.23 | 8,634 | 7,562 |
|
Chee Houe Woo
405 Silverside Rd Ste 104 |
$18.69 | 8,541 | 6,209 |
|
Brandywine Pediatrics, P.A.
3521 Silverside Rd |
$55.79 | 8,452 | 6,841 |
|
Delaware Pediatrics
1202 Foulk Rd |
$47.29 | 8,318 | 6,022 |
|
The Life Center Complex, Inc
1624 Jessup St |
$34.19 | 7,990 | 4,576 |
|
Southbridge Medical Advisory Council Inc
601 New Castle Ave |
$0.81 | 7,683 | 5,085 |
|
Complete Family Care, Inc
534 Greenhill Ave |
$66.64 | 7,629 | 6,857 |
|
Iman Sharif
1600 Rockland Road |
$122.76 | 7,559 | 6,896 |
|
Patrick K. Owusu
7Th & Clayton Sts |
$34.35 | 7,074 | 3,182 |
|
Serene Minds, Llc
410 Foulk Rd |
$63.77 | 6,992 | 6,311 |
|
Jean Louise Binkley
4515 Griffin Dr |
$108.68 | 6,750 | 6,241 |
|
St Francis Hospital Inc
701 N Clayton St |
$62.55 | 6,540 | 5,141 |
|
Heritage Medical Associates, P.A.
2601 Annand Dr Ste 4 |
$77.74 | 6,268 | 5,016 |
|
A Radford Macfarlane Md
4512 Kirkwood Hwy |
$49.35 | 6,024 | 5,065 |
|
Norman Broudy
825 N Washington St |
$45.75 | 6,008 | 4,987 |
|
Amaka Anuli Akalonu
1600 Rockland Rd |
$67.83 | 5,958 | 5,861 |
|
Harmonious Mind Llc
5189 W Woodmill Dr |
$70.00 | 5,807 | 5,271 |
|
Advanced Care Obstetrics And Gynecology Pa
1941 Limestone Rd Ste 217 |
$83.58 | 5,557 | 4,065 |
|
Planned Parenthood Of Delaware, Inc.
625 N Shipley St. |
$60.45 | 4,589 | 4,075 |
|
Psychiatry Delaware Company Llc
1415 Foulk Rd Ste 104 |
$35.41 | 4,578 | 3,447 |
|
Delaware Pain & Spine Center, Inc.
2055 Limestone Rd |
$32.73 | 4,491 | 2,968 |
|
Irwin L. Lifrak, M.D., P.A.
1010 N Union St |
$63.00 | 4,423 | 1,662 |
|
Zarek Donohue Llc
3411 Silverside Rd Ste 100 |
$47.79 | 4,355 | 3,186 |
|
St. Francis Hospital Inc.
2002 Foulk Rd |
$38.36 | 4,108 | 3,072 |
|
Jenika Miles
4420 Limestone Rd Ste 307 |
$26.24 | 4,047 | 3,819 |
|
Pasquale Fucci
1815 W 13Th St |
$7.40 | 3,873 | 2,746 |
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 Wilmington, DE?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Wilmington, DE is $55.68 per claim, based on 1,174,146 claims from 633 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 Wilmington, DE?
There are 633 Medicaid providers offering Office Visit related services in Wilmington, DE according to public payment data.
What is the price range for Office Visit in Wilmington, DE?
Medicaid reimbursement for Office Visit in Wilmington, DE ranges from $0.00 to $262.09 per claim, with an average of $55.68. 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 Wilmington, DE
Personal Care Services
Avg $113.14
1,523,473 claims
Substance Abuse Treatment
Avg $14.51
1,110,493 claims
Vaccines & Immunizations
Avg $9.43
497,265 claims
Dental Cleaning & Exam
Avg $47.53
375,713 claims
Emergency Room Visit
Avg $187.07
346,985 claims
Physical Therapy
Avg $30.41
305,435 claims
Psychiatric Evaluation
Avg $47.31
297,416 claims
Blood Work & Lab Tests
Avg $19.23
287,397 claims