Based on public Medicaid payment data.

Average Medicaid Prescription Medications Payments in Philadelphia, PA: $25.26

Avg. Paid

$25.26

Range

$0.00 – $1,216

Total Claims

75,022

Providers

Typical Payment Range

Typical Medicaid Prescription Medications payments fall between $0.68 and $14.54 per claim (median: $2.87). The top 10% of payments exceed $78.92.

Based on per-provider averages across all Medicaid claims in this category.

Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.

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 Prescription Medications in Philadelphia, PA

Provider	Avg. Paid	Claims	Patients
Childrens Hospital Of Philadelphia 34Th And Civic Center Blvd	$100.86	10,957	8,728
Stc Opco Llc 160 E Erie Ave	$0.24	6,242	5,730
Dva Healthcare Of Pennsylvania Llc 4126 Walnut St	$0.00	4,737	409
Dva Healthcare Renal Care Inc 1700 S 60Th St	$0.00	3,841	328
Dva Healthcare Of Pennsylvania Llc 3823 Market St	$0.00	3,328	292
Total Renal Care Inc 449 N Broad St	$0.00	3,071	267
Renal Treatment Centers Northeast Inc 1172 S Broad St	$0.00	2,574	247
Isd Renal Inc 5933 N Broad St	$0.00	2,558	228
Dva Healthcare Of Pennsylvania Llc 3701 Market St	$0.00	2,498	214
Renal Treatment Centers Northeast Inc 518 Knorr St	$0.00	2,462	211
Total Renal Care Inc 150 S Independence Mall W	$0.00	2,422	220
Red Willow Dialysis Llc 7198 Castor Ave	$0.00	2,415	208
Isd Renal Inc 3310 Memphis St	$0.00	2,298	195
Renal Treatment Centers Northeast Inc 109 Dickinson St	$0.00	2,271	217
Dialysis Clinic Inc. 3300 Henry Ave	$0.00	2,147	1,143
Renal Center Of Philadelphia, Llc 5630 Chestnut St	$0.00	2,105	288
Physicians Dialysis Acquisitions Inc 834 Walnut St	$0.00	1,903	166
Dva Healthcare Renal Care Inc 7609 Lindbergh Blvd	$0.00	1,771	158
St. Christopher'S Healthcare, Llc 160 E Erie Ave	$0.78	1,765	1,730
Total Renal Care Inc 400 N 3Rd St	$0.00	1,423	130
Sara B Pentlicky 5501 Old York Rd Ste 3	$46.19	826	812
Total Renal Care Inc 3020 Market St	$0.00	815	70
Patrick Wang 245 N 15Th St	$13.31	802	709
Jessica Intravia 1015 Walnut St Ste 620	$16.09	764	738
Shriners Hospitals For Children 3551 N Broad St	$3.25	720	585
Steven G Dimitriou 227 N Broad St Ste 301	$0.00	660	56
Thomas Jefferson University Hospitals Inc 111 S 11Th St	$0.90	530	314
Gary W. Muller 7604 Central Ave	$6.07	520	516
Anton M Kolomeyer 2701 Holme Ave Ste 303	$672.83	456	347
Total Renal Care Inc 4508 City Line Ave	$0.00	434	36
Michael Richard Silver 834 Chestnut St	$502.53	414	311
Temple University Hospital, Inc 3401 N Broad St	$0.08	405	354
Corey Kades Ruth 1500 Market Street	$0.20	388	380
Michael J Suchar Erie Ave At Front Street	$0.00	273	260
Rachel Georgopoulos 3401 N Broad St	$2.35	241	182
Kevin Refaat Kammel 230 N Broad St	$11.86	240	224
Monica Marie Orji 3400 Spruce St	$39.69	240	217
Joseph Henry Castellanos 3401 Civic Center Blvd	$3.54	216	209
Judy Politzer 1401 S 31St St	$0.00	214	211
Kunal Kumar 5401 Old York Rd Ste 300	$485.46	207	98
Trustees Of The University Of Pennsylvania 3400 Spruce St	$0.01	200	169
Oliver Sacks 5501 Old York Rd	$3.31	167	134
Matthew Peter Ognibene 230 N Broad St	$1.19	161	131
Alexander Gaitanis 5501 Old York Rd Ste 1	$6.47	144	73
Stephen Gray 100 E Lehigh Ave	$0.00	123	119
Geoffrey Everett 160 E Erie Ave	$0.00	117	106
John Tio Saludades 3509 N Broad St	$0.00	114	97
David Alan Zwillenberg 3601 A Street	$0.00	105	96
Pramath Nath 160 E Erie Ave	$0.00	97	79
Nazareth Hospital 2601 Holme Ave	$0.02	94	92

What to Expect: Prescription Medications

Medicaid covers most medically necessary prescription medications. Your copay is typically $0-3 for generic drugs and $0-5 for brand-name drugs. Some medications require prior authorization. Most prescriptions can be filled at any participating pharmacy. Mail-order pharmacy may be available for maintenance medications. 90-day supplies may be available for chronic conditions.

Cost Components

National average Medicaid payment per billing code. Individual rates vary by provider and state.

Code	Description	Avg. Paid	Claims	Providers
J1100	Dexamethasone sodium phos	$3.37	17,408,335	19,920
J1270	Injection, doxercalciferol	$16.67	15,455,545	1,785
J0696	Ceftriaxone sodium injection	$4.52	8,442,343	9,869
J1170	Hydromorphone injection	$3.20	6,069,586	3,002
J1200	Diphenhydramine hcl injectio	$3.10	5,922,771	3,790
J0690	Cefazolin sodium injection	$5.07	4,950,109	2,942
J1050	Medroxyprogesterone acetate	$38.04	2,722,661	5,740
J0131	Inj, acetaminophen (nos)	$15.79	2,017,135	1,612
J1030	Methylprednisolone 40 mg inj	$5.08	1,577,497	4,461
J0882	Darbepoetin alfa, esrd use	$63.10	1,115,197	646
J1040	Methylprednisolone 80 mg inj	$6.39	1,102,119	2,895
J0585	Injection,onabotulinumtoxina	$534.00	949,108	1,450
J0702	Betamethasone acet&sod phosp	$9.01	907,372	2,580
J0780	Prochlorperazine injection	$4.11	869,130	1,089
J0178	Aflibercept injection	$802.42	747,781	1,182
J0171	Adrenalin epinephrine inject	$5.61	533,091	956
J0897	Denosumab injection	$708.53	175,698	394
J1071	Inj testosterone cypionate	$3.01	121,666	206
J0636	Inj calcitriol per 0.1 mcg	$2.19	94,974	28
J0885	Epoetin alfa, non-esrd	$82.64	88,458	179
J1020	Methylprednisolone 20 mg inj	$3.48	88,065	344
J0881	Darbepoetin alfa, non-esrd	$149.52	63,199	108
J0878	Daptomycin injection	$167.80	55,762	36
J1245	Dipyridamole injection	$5.21	54,912	138
J0592	Buprenorphine hydrochloride	$15.56	48,440	32
J0153	Adenosine inj 1mg	$18.75	46,321	143
J0670	Inj mepivacaine hcl/10 ml	$0.91	37,668	90
J0129	Abatacept injection	$1,614	34,397	89
J0735	Clonidine hydrochloride	$6.85	32,191	92
J0610	Calcium glucon (fresenius)	$9.34	31,253	88
J0135	Adalimumab injection	$738.85	28,382	35
J1094	Inj dexamethasone acetate	$2.39	27,586	144
J0717	Certolizumab pegol inj 1mg	$2,072	22,279	41
J0697	Sterile cefuroxime injection	$0.94	18,132	47
J0256	Alpha 1 proteinase inhibitor	$2,389	16,156	1
J1250	Inj dobutamine hcl/250 mg	$6.92	14,579	60
J0588	Incobotulinumtoxin a	$295.98	10,950	18
J1325	Epoprostenol injection	$636.33	9,713	5
J1240	Dimenhydrinate injection	$0.02	8,738	12
J1000	Depo-estradiol cypionate inj	$11.84	1,738	11
J1230	Methadone injection	$4.00	1,439	2
J1212	Dimethyl sulfoxide 50% 50 ml	$175.32	1,145	5
J1265	Dopamine injection	$2.67	840	1
J0132	Acetylcysteine injection	$0.11	814	6
J0834	Inj., cosyntropin, 0.25 mg	$60.82	696	6
J1120	Acetazolamid sodium injectio	$8.30	446	4
J0713	Inj ceftazidime per 500 mg	$8.01	398	5
J0698	Cefotaxime sodium injection	$0.61	371	9
J0775	Collagenase, clost hist inj	$9,463	323	1
J0207	Amifostine	$23.74	42	—
J0120	Tetracyclin injection	—	—	—
J0133	Acyclovir injection	—	—	—
J0202	Injection, alemtuzumab	—	—	—
J0795	Corticorelin ovine triflutal	—	—	—
J1160	Digoxin injection	—	—	—
J1205	Chlorothiazide sodium inj	—	—	—
J1260	Dolasetron mesylate	—	—	—
J1290	Ecallantide injection	—	—	—
J1300	Eculizumab injection	—	—	—
J1301	Injection, edaravone, 1 mg	—	—	—
J1303	Inj., ravulizumab-cwvz 10 mg	—	—	—
J1305	Inj, evinacumab-dgnb, 5mg	—	—	—
J1320	Amitriptyline injection	—	—	—
J1322	Elosulfase alfa, injection	—	—	—
J1327	Eptifibatide injection	—	—	—

These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.

Frequently Asked Questions

How much does a Prescription Medications cost in Philadelphia, PA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Philadelphia, PA is $25.26 per claim, based on 75,022 claims from 93 providers. Typical payments fall between $0.68 and $14.54. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.

How many providers offer Prescription Medications in Philadelphia, PA?

There are 93 Medicaid providers offering Prescription Medications related services in Philadelphia, PA according to public payment data.

What is the price range for Prescription Medications in Philadelphia, PA?

Medicaid reimbursement for Prescription Medications in Philadelphia, PA ranges from $0.00 to $1,216 per claim, with an average of $25.26. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Prescription Medications Payments in Philadelphia, PA: $25.26

Providers Offering Prescription Medications in Philadelphia, PA

What to Expect: Prescription Medications

Cost Components

Frequently Asked Questions

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