Average Medicaid Prescription Medications Payments in Pittsburgh, PA: $62.21
Avg. Paid
$62.21
Range
$0.00 – $1,441
Total Claims
4,134
Providers
37
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 Pittsburgh, PA
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Upmc Children'S Hospital Of Pittsburgh
4401 Penn Ave |
$40.43 | 1,799 | 1,628 |
|
Ashley Bruce
4815 Liberty Ave Ste Gr50 |
$91.26 | 426 | 419 |
|
John Glenn Burkett
4815 Liberty Ave Ste 439 |
$478.74 | 255 | 137 |
|
Joseph Noga
2 Hot Metal St |
$0.01 | 247 | 231 |
|
Heather Ilycia Baumhardt
3Rd Floor Main Hospital Bldg |
$0.00 | 216 | 214 |
|
Douglas A Potoka
3705 5Th Ave |
$0.00 | 162 | 128 |
|
Daniel M Malkamaki
2585 Freeport Rd Ste 105 |
$0.02 | 140 | 128 |
|
Amr Habbach
320 E North Ave |
$0.80 | 128 | 12 |
|
Vanessa Ferla
320 E North Ave |
$2.11 | 104 | 89 |
|
Brian Stephen Martin
45Th And Penn Avenue |
$0.00 | 95 | 93 |
|
Nicole J Jarrett
3550 Terrace St |
$10.88 | 71 | 53 |
|
Rehan Raza Ahmad
320 E North Ave |
$0.06 | 40 | 39 |
|
Sean Button
4401 Penn Ave |
$0.00 | 29 | 29 |
|
Glenn Martin Cannon
1 Childrens Hospital Dr |
$0.36 | 29 | 29 |
|
Allison Tobey
Division Of Pediatric Otolaryngology, Upmc Children'S |
$0.00 | 28 | 28 |
|
Noel Jabbour
4401 Penn Ave |
$0.00 | 27 | 27 |
|
Robert Hickey
3414 5Th Ave |
$0.00 | 27 | 27 |
|
Patrick Joseph Bovino
2 Hot Metal Street |
$0.03 | 26 | 26 |
|
Johanna Rosen
427 Peebles St |
$0.00 | 25 | 25 |
|
Raymond D Pitetti
3705 5Th Ave |
$0.00 | 25 | 25 |
|
Joseph Dohar
3705 5Th Ave |
$0.00 | 17 | 16 |
|
Rajeev Chaudhry
4401 Penn Ave |
$0.00 | 16 | 16 |
|
Rhett H Lieberman
3705 5Th Ave |
$0.00 | 16 | 16 |
|
Nancy Rixe
4401 Penn Ave |
$0.00 | 15 | 15 |
|
Unoma Obiajulu Akamagwuna
3471 5Th Ave |
$1,441 | 15 | 12 |
|
Mary Chapman
4401 Penn Ave |
$0.00 | 14 | 14 |
|
Nicole Helene D'Alessandro
5200 Centre Ave |
$0.00 | 14 | 14 |
|
Meghan Christie
230 Mckee Pl Ste 500 |
$0.04 | 14 | 14 |
|
Dennis Joseph Kitsko
3705 5Th Ave |
$0.00 | 14 | 14 |
|
Amanda Stapleton
4401 Penn Ave |
$0.00 | 14 | 14 |
|
Richard Andrew Rowland
320 E North Ave |
$0.00 | 13 | 12 |
|
Devora Azhdam
Children'S Hospital Of Pittsburgh |
$0.00 | 13 | 13 |
|
Erin D Phrampus
4401 Penn Ave |
$0.00 | 12 | 12 |
|
Courtney Crain
4401 Penn Ave |
$51.10 | 12 | 12 |
|
Desiree Noel Wagner Neville
4401 Penn Ave |
$0.00 | 12 | 12 |
|
Stephen J Janofsky
4401 Penn Avenue |
$0.00 | 12 | 12 |
|
Paul Morgan Wilkie
1304 Federal St |
$12.61 | 12 | 12 |
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 Pittsburgh, PA?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Pittsburgh, PA is $62.21 per claim, based on 4,134 claims from 37 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 Pittsburgh, PA?
There are 37 Medicaid providers offering Prescription Medications related services in Pittsburgh, PA according to public payment data.
What is the price range for Prescription Medications in Pittsburgh, PA?
Medicaid reimbursement for Prescription Medications in Pittsburgh, PA ranges from $0.00 to $1,441 per claim, with an average of $62.21. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Prescription Medications in Other Cities
Phoenix, AZ
Avg $16.15
844,810 claims · 235 providers
Milwaukee, WI
Avg $9.22
755,550 claims · 88 providers
Washington, DC
Avg $6.48
675,765 claims · 92 providers
Los Angeles, CA
Avg $61.23
617,979 claims · 282 providers
Louisville, KY
Avg $31.67
601,676 claims · 181 providers
New York, NY
Avg $40.26
587,024 claims · 195 providers
San Diego, CA
Avg $27.34
493,429 claims · 162 providers
Tucson, AZ
Avg $24.34
489,015 claims · 169 providers
Other Procedures in Pittsburgh, PA
Blood Work & Lab Tests
Avg $12.74
5,898,610 claims
Office Visit
Avg $58.11
1,594,344 claims
Emergency Room Visit
Avg $104.00
1,342,847 claims
Urinalysis & Urine Tests
Avg $4.28
839,744 claims
X-Ray
Avg $8.11
814,115 claims
Culture & Microbiology Tests
Avg $5.35
530,883 claims
Physical Therapy
Avg $57.35
415,480 claims
EKG / ECG (Electrocardiogram)
Avg $8.10
404,951 claims