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 |
|---|---|---|---|
|
David A Paniccia
2410 Ridgeway Ave |
$16.49 | 12 | 12 |
|
Inna Buzhor
601 Elmwood Ave |
$0.63 | 12 | 12 |
|
Julie S Albert
819 W Main St |
$78.62 | 12 | 12 |
|
Theresa Shaw
1445 Portland Ave Ste 302 |
$1.10 | 12 | 12 |
|
Olivia Higgins
1415 Portland Ave Ste 400 |
$85.50 | 12 | 12 |
|
Patricia Amanda Weir
601 Elmwood Ave |
$0.34 | 13 | 13 |
|
Marthalyn Sweet
114 University Ave |
$59.48 | 13 | 13 |
|
Bilal Mahmood
601 Elmwood Ave |
$8.54 | 13 | 13 |
|
Roger Joseph Chapman
82 Holland St |
$0.57 | 13 | 13 |
|
Tara Marie Petroski
1425 Portland Ave # 304 |
$0.00 | 13 | 13 |
|
Julia Maccallum
125 Lattimore Rd Ste 200 |
$86.11 | 14 | 14 |
|
Karl B Michalko
360 Linden Oaks |
$6.38 | 14 | 13 |
|
William Daya
601 Elmwood Ave |
$1.86 | 14 | 12 |
|
Thomas J Belt
1555 Long Pond Rd |
$3.06 | 14 | 12 |
|
Strong Obstetrics-Gynecology Group
601 Elmwood Ave |
$26.03 | 14 | 14 |
|
Jennifer A Gargano
10 Hagen Dr Lowr Level |
$7.00 | 15 | 15 |
|
Steven J Rose
160 Sawgrass Dr |
$579.21 | 15 | 12 |
|
Mark H Mirabelli
601 Elmwood Ave |
$31.69 | 16 | 16 |
|
Tracey Demino
1000 South Ave |
$0.00 | 16 | 15 |
|
Emily E Carmody
601 Elmwood Ave |
$253.51 | 17 | 15 |
|
Lorinda F Parks
2350 Ridgeway Ave Ste A |
$24.88 | 25 | 25 |
|
Angela Pugliese Bessette
210 Crittenden Blvd |
$526.95 | 25 | 25 |
|
Megan B Vaules
2655 Ridgeway Ave |
$53.46 | 25 | 25 |
|
Heather Sullivan
330 Monroe Ave |
$72.00 | 25 | 25 |
|
Anthony L. Jordan Health Corporation
82 Holland Street |
$8.10 | 25 | 25 |
|
Katherine H Rizzone
601 Elmwood Ave |
$9.63 | 27 | 25 |
|
Michael Gruttadauria
1081 Long Pond Rd |
$2.89 | 28 | 28 |
|
University Of Rochester
155 Bellwood Dr |
$8.11 | 29 | 28 |
|
Louise Carroll
1415 Portland Ave Ste 400490 |
$84.62 | 29 | 29 |
|
Emily Aman
601 Elmwood Ave |
$63.54 | 30 | 29 |
|
Meenu Mittal Jindal
601 Elmwood Ave # 632B |
$0.70 | 33 | 14 |
|
Christine Elizabeth Patrissi
114 University Ave |
$51.18 | 34 | 27 |
|
Nathalia Moraes Figueiredo
919 Westfall Rd Ste 220 |
$90.72 | 39 | 12 |
|
James Craig Azurin
2101 Lac Deville Boulevard |
$1,128 | 42 | 38 |
|
Merielle Stephens
125 Lattimore Rd Ste 150 |
$72.00 | 43 | 43 |
|
Susan Lynn Putrelo-Summers
855 W Main St |
$0.74 | 45 | 45 |
|
Cynthia Louise Bonner
114 University Ave |
$40.36 | 48 | 38 |
|
Danielle Marie Wilbur
601 Elmwood Ave, |
$8.99 | 49 | 49 |
|
Maria V Karipidis Pouria
20 S Clinton Ave |
$27.17 | 50 | 50 |
|
Carla Ann Scheiber
999 E Ridge Rd |
$69.11 | 51 | 51 |
|
Steven J Posnick
880 Westfall Rd |
$14.80 | 51 | 51 |
|
Mary Elizabeth Bostock
990 South Ave |
$83.68 | 53 | 52 |
|
The Unity Hospital Of Rochester
100 Kings Hwy S |
$31.50 | 55 | 55 |
|
Davya S. Brody
82 Holland St |
$36.87 | 55 | 55 |
|
Kara Lee Eastwood
2655 Ridgeway Ave |
$78.52 | 58 | 58 |
|
Constantinos Ketonis
601 Elmwood Ave, |
$17.60 | 64 | 64 |
|
Katharine Lynn Kurtz
1425 Portland Ave |
$0.75 | 64 | 64 |
|
Justin Lawrence Cherubim
620 Park Ave # 181 |
$0.47 | 70 | 70 |
|
Peter A Mroz
222 Alexander St |
$57.65 | 71 | 71 |
|
Jillian Elizabeth Digiovanna
1415 Portland Ave |
$55.94 | 94 | 82 |
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