Average Medicaid Prescription Medications Payments in Rochester, NY: $53.52
Avg. Paid
$53.52
Range
$0.00 – $1,128
Total Claims
89,574
Providers
85
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 Rochester, NY
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
U Of R Neurology Department
601 Elmwood Ave |
$24.10 | 21,798 | 19,626 |
|
University Of Rochester
601 Elmwood Ave |
$96.18 | 15,429 | 13,838 |
|
Rochester General Hospital
1425 Portland Ave |
$17.23 | 13,075 | 11,747 |
|
Planned Parenthood Of Central And Western New York, Inc
114 University Ave |
$13.06 | 10,109 | 10,101 |
|
The Unity Hospital Of Rochester
1555 Long Pond Rd |
$57.86 | 7,505 | 6,769 |
|
Highland Hospital Of Rochester
1000 South Ave |
$2.41 | 6,958 | 5,949 |
|
Rochester General Hospital
370 Ridge Rd E |
$251.53 | 4,521 | 1,334 |
|
Mohamad Mahmoud
100 Kings Hwy S |
$79.65 | 725 | 725 |
|
Julia Stroud
755 Jefferson Rd |
$65.97 | 654 | 621 |
|
Rebecca Leigh Alicandro
65 Genesee St 1St Floor, Ste 3 |
$74.76 | 546 | 546 |
|
Ellen J. Tourtelot
125 Lattimore Rd |
$71.24 | 546 | 546 |
|
Karen Nicole Finklea
82 Holland St |
$25.61 | 532 | 532 |
|
Leigh Ann Quenasse
114 University Ave |
$69.02 | 530 | 503 |
|
Amanda Schnorf
2824 W Ridge Rd |
$61.83 | 473 | 448 |
|
Benjamin Ray Christensen
200 White Spruce Blvd |
$29.95 | 451 | 451 |
|
Judith E Kerpelman
1415 Portland Ave |
$83.74 | 423 | 423 |
|
Hollis Ann Biggs
145 Parsells Ave |
$36.55 | 404 | 404 |
|
Kate Grant
2619 Culver Rd Ste 2A |
$8.23 | 347 | 330 |
|
Paul Anthony Cabral
1415 Portland Ave |
$78.71 | 319 | 319 |
|
Juliana Moshier
114 University Ave |
$64.43 | 279 | 260 |
|
Ilya Voloshin
601 Elmwood Ave |
$16.76 | 210 | 208 |
|
Rachael Phelps
114 University Ave |
$73.63 | 202 | 202 |
|
Gloria Jean Fluellen
601 Elmwood Ave |
$73.32 | 183 | 183 |
|
Angela Ehlinger
114 University Ave |
$66.79 | 179 | 174 |
|
Ya Li Chen
222 Alexander St |
$6.59 | 177 | 176 |
|
Sharmeen Fatima Hussaini
2180 S Clinton Ave |
$0.00 | 164 | 161 |
|
Kyla Rae Marte
601 Elmwood Ave |
$66.06 | 161 | 139 |
|
Nicole Paul
454 E Broad St Ste 100 |
$63.81 | 159 | 153 |
|
Christine Anne Blonski
2619 Culver Rd Ste 2A |
$7.85 | 156 | 153 |
|
Rehan Bin Asif
1415 Portland Ave Ste 490 |
$83.67 | 138 | 138 |
|
Lauren E. Smith
114 University Ave |
$70.17 | 135 | 130 |
|
Matthew T Witmer
160 Sawgrass Dr |
$933.85 | 131 | 129 |
|
Sareena Fazili
500 Island Cottage Rd |
$77.97 | 120 | 120 |
|
Carol Elizabeth Rodriguez
1415 Portland Ave Ste 400 |
$83.65 | 112 | 112 |
|
Ryan V Evans
20 Hagen Dr |
$1,007 | 112 | 104 |
|
Jillian Elizabeth Digiovanna
1415 Portland Ave |
$55.94 | 94 | 82 |
|
Peter A Mroz
222 Alexander St |
$57.65 | 71 | 71 |
|
Justin Lawrence Cherubim
620 Park Ave # 181 |
$0.47 | 70 | 70 |
|
Constantinos Ketonis
601 Elmwood Ave, |
$17.60 | 64 | 64 |
|
Katharine Lynn Kurtz
1425 Portland Ave |
$0.75 | 64 | 64 |
|
Kara Lee Eastwood
2655 Ridgeway Ave |
$78.52 | 58 | 58 |
|
The Unity Hospital Of Rochester
100 Kings Hwy S |
$31.50 | 55 | 55 |
|
Davya S. Brody
82 Holland St |
$36.87 | 55 | 55 |
|
Mary Elizabeth Bostock
990 South Ave |
$83.68 | 53 | 52 |
|
Steven J Posnick
880 Westfall Rd |
$14.80 | 51 | 51 |
|
Carla Ann Scheiber
999 E Ridge Rd |
$69.11 | 51 | 51 |
|
Maria V Karipidis Pouria
20 S Clinton Ave |
$27.17 | 50 | 50 |
|
Danielle Marie Wilbur
601 Elmwood Ave, |
$8.99 | 49 | 49 |
|
Cynthia Louise Bonner
114 University Ave |
$40.36 | 48 | 38 |
|
Susan Lynn Putrelo-Summers
855 W Main St |
$0.74 | 45 | 45 |
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 Rochester, NY?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Rochester, NY is $53.52 per claim, based on 89,574 claims from 85 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 Rochester, NY?
There are 85 Medicaid providers offering Prescription Medications related services in Rochester, NY according to public payment data.
What is the price range for Prescription Medications in Rochester, NY?
Medicaid reimbursement for Prescription Medications in Rochester, NY ranges from $0.00 to $1,128 per claim, with an average of $53.52. 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 Rochester, NY
Home Health Visit
Avg $155.96
4,468,559 claims
Blood Work & Lab Tests
Avg $13.58
3,406,771 claims
Office Visit
Avg $80.81
3,372,720 claims
Emergency Room Visit
Avg $129.50
1,243,277 claims
Case Management Services
Avg $416.23
1,188,020 claims
Psychiatric Evaluation
Avg $142.49
1,087,559 claims
Substance Abuse Treatment
Avg $66.55
788,422 claims
Physical Therapy
Avg $59.14
727,107 claims