Average Medicaid Prescription Medications Payments in Sheboygan, WI: $0.62
Avg. Paid
$0.62
Range
$0.00 – $166.14
Total Claims
56,876
Providers
10
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 Sheboygan, WI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Aurora Health Care Central, Inc.
3400 Union Ave |
$0.01 | 20,093 | 15,558 |
|
Total Renal Care Inc
1338 N Taylor Dr |
$0.02 | 13,433 | 990 |
|
St Nicholas Hospital-Sisters Of The Third Order Of St. Francis
2925 Saemann Ave |
$0.02 | 11,166 | 1,326 |
|
St. Nicholas Hospital-Sisters Of The Third Order Of St Francis
3100 Superior Ave |
$0.00 | 10,176 | 7,900 |
|
Planned Parenthood Of Wisconsin
2108 Kohler Memorial Dr |
$17.54 | 924 | 896 |
|
Raymond Seth Sohn
2124 Kohler Memorial Dr Ste 110 |
$0.91 | 427 | 246 |
|
Atit Shah
2124 Kohler Memorial Dr Ste 110 |
$0.86 | 296 | 155 |
|
Jeremy Ashton Scarlett
2124 Kohler Memorial Dr Ste 110 |
$0.53 | 239 | 128 |
|
Thomas John Zweifel
3113 Saemann Ave |
$166.14 | 106 | 25 |
|
Ekaterina V Soforo
1414 N Taylor Dr Ste 110 |
$11.52 | 16 | 14 |
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 Sheboygan, WI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Sheboygan, WI is $0.62 per claim, based on 56,876 claims from 10 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 Sheboygan, WI?
There are 10 Medicaid providers offering Prescription Medications related services in Sheboygan, WI according to public payment data.
What is the price range for Prescription Medications in Sheboygan, WI?
Medicaid reimbursement for Prescription Medications in Sheboygan, WI ranges from $0.00 to $166.14 per claim, with an average of $0.62. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Prescription Medications in Other Cities
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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
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Tucson, AZ
Avg $24.34
489,015 claims · 169 providers
Other Procedures in Sheboygan, WI
Substance Abuse Treatment
Avg $10.92
394,657 claims
Behavioral & Mental Health Therapy
Avg $74.26
268,608 claims
Blood Work & Lab Tests
Avg $9.48
200,473 claims
Office Visit
Avg $31.92
196,151 claims
Personal Care Services
Avg $6.96
187,806 claims
Emergency Room Visit
Avg $52.42
144,586 claims
Physical Therapy
Avg $32.00
138,897 claims
Speech Therapy
Avg $10.74
129,415 claims