Average Medicaid Office Visit Payments in Wilmington, OH: $43.62
Avg. Paid
$43.62
Range
$0.40 – $112.28
Total Claims
249,036
Providers
86
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, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Lenora A Fitton
630 W Main St Ste 105 |
$45.52 | 16,174 | 14,225 |
|
Carrie B Fairchild
610 W Main St |
$45.08 | 15,651 | 13,894 |
|
Laura R Smith
140 W Main St |
$29.29 | 14,917 | 8,562 |
|
Rachel Sneed
140 W Main St |
$25.38 | 13,194 | 7,851 |
|
Cory L Pelnick
953 S South Street |
$81.42 | 11,416 | 10,354 |
|
Cheyenne M Gasaway
630 W Main St Ste 300 |
$42.97 | 8,594 | 7,700 |
|
Melissa Gayle Holmes
2845 Progress Way |
$27.55 | 8,094 | 5,855 |
|
John William Merling
1184 W Locust St |
$52.69 | 8,080 | 6,852 |
|
Jason L Rich
485 W Main St |
$77.67 | 7,833 | 6,443 |
|
Alison Meager
485 W Main St |
$112.28 | 7,615 | 5,871 |
|
Tracy Resibois-Binkley
2107 Rombach Ave |
$32.05 | 7,475 | 5,830 |
|
Roseanne Elizabeth Mckay
140 W Main St |
$23.76 | 5,859 | 3,351 |
|
Christopher Donald Lawley
1150 W Locust St |
$29.89 | 5,812 | 5,267 |
|
Michael L Clark
596 W Main St |
$40.63 | 5,427 | 4,240 |
|
John T Hollon
222 W Main St |
$40.11 | 4,605 | 3,951 |
|
Amanda Paulson
2107 Rombach Ave |
$44.46 | 4,563 | 4,180 |
|
Greater Tomorrow Health, Llc
2107 Rombach Ave |
$42.76 | 4,457 | 4,121 |
|
John Mehnert
630 W Main St |
$30.35 | 4,266 | 3,625 |
|
Andrea K Howard
212 S South St Unit A |
$43.66 | 4,107 | 3,922 |
|
Philip Constandi Aschi
781 W Locust St |
$33.69 | 3,983 | 3,631 |
|
Paige Nicole Shreffler
2107 Rombach Ave |
$44.15 | 3,876 | 3,556 |
|
Puja Srivastava
485 W Main St |
$44.56 | 3,806 | 2,061 |
|
Shaun Patrick Jester
2241 Rombach Ave |
$31.63 | 3,213 | 2,269 |
|
Edward M Onusko
825 W Locust St |
$55.84 | 3,185 | 3,097 |
|
Linda J Brackett
630 W Main St Ste 102 |
$42.61 | 3,176 | 2,342 |
|
Ross S Wickstrom
1184 W Locust St |
$43.54 | 3,049 | 2,844 |
|
Tina M Gabbard
1184 W Locust St |
$41.88 | 3,028 | 2,616 |
|
Sheila C Llanes-Diopita
1184 W Locust St |
$43.77 | 2,957 | 2,747 |
|
Surmeet Bedi
630 W Main St |
$24.73 | 2,913 | 2,610 |
|
Karla Marie Dean
140 W Main St |
$26.78 | 2,874 | 1,651 |
|
Mary Ann Haneberg-Merling
1184 W Locust St |
$45.34 | 2,676 | 2,544 |
|
Maryann V. Daffeh
610 W Main St |
$25.60 | 2,501 | 2,001 |
|
Rajiv R Patel
630 W Main St Ste 102 |
$51.58 | 2,485 | 2,233 |
|
Brian J Santin
630 W Main St |
$33.44 | 2,358 | 2,195 |
|
Jaime Lynn Evanshine
630 W Main St |
$41.26 | 2,268 | 2,031 |
|
Vidyashankar B Revan
110 Fairway Dr |
$41.68 | 2,198 | 2,059 |
|
Ronald Joseph Pedalino
610 W Main St |
$11.96 | 2,182 | 1,332 |
|
Tiffany Burroughs
1184 W Locust St |
$44.46 | 2,179 | 2,027 |
|
Laura A Clutter
1184 W Locust St |
$41.85 | 2,104 | 1,977 |
|
Healthsource Of Ohio, Inc.
140 W Main St |
$0.40 | 1,930 | 1,706 |
|
Juliane Stanton
2845 Progress Way |
$37.45 | 1,915 | 1,508 |
|
Tracy Dean Kelley
630 W Main St Ste 207 |
$36.38 | 1,902 | 1,837 |
|
Carrie Cooper-Fenske Sanan
596 W Main St |
$55.54 | 1,881 | 1,671 |
|
Christopher M Wright
1150 W Locust St Ste 300 |
$36.43 | 1,803 | 1,704 |
|
Cynthia A Bevan
1175 Airport Rd |
$43.27 | 1,770 | 1,589 |
|
M. Niranjan Reddy
630 W Main St Ste 105 |
$45.23 | 1,644 | 1,583 |
|
Katy E Meeker
1184 W Locust St |
$45.44 | 1,594 | 1,478 |
|
James Craig Strafford
485 W Main St |
$53.95 | 1,563 | 1,255 |
|
Gerald Perelman
1435 Rombach Ave |
$23.79 | 1,537 | 1,387 |
|
Jeffrey David Manser
1150 W Locust St |
$47.76 | 1,391 | 1,339 |
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, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Office Visit in Wilmington, OH is $43.62 per claim, based on 249,036 claims from 86 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, OH?
There are 86 Medicaid providers offering Office Visit related services in Wilmington, OH according to public payment data.
What is the price range for Office Visit in Wilmington, OH?
Medicaid reimbursement for Office Visit in Wilmington, OH ranges from $0.40 to $112.28 per claim, with an average of $43.62. 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, OH
Substance Abuse Treatment
Avg $31.25
463,030 claims
Blood Work & Lab Tests
Avg $6.04
117,739 claims
Emergency Room Visit
Avg $81.92
99,588 claims
Behavioral & Mental Health Therapy
Avg $59.61
56,535 claims
Vaccines & Immunizations
Avg $10.10
50,209 claims
Urinalysis & Urine Tests
Avg $2.11
35,003 claims
Psychiatric Evaluation
Avg $64.98
33,845 claims
EKG / ECG (Electrocardiogram)
Avg $4.42
30,833 claims