Average Medicaid Prescription Medications Payments in Sterling Heights, MI: $4.44
Avg. Paid
$4.44
Range
$0.11 – $48.82
Total Claims
29,333
Providers
29
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 Sterling Heights, MI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Hillsdale Pediatric Clinic Pc
3755 15 Mile Rd |
$1.98 | 11,620 | 8,693 |
|
Laith Potrous Md Pllc
5843 17 Mile Rd |
$0.52 | 4,476 | 3,954 |
|
Mendelson Orthopedics Pc
35735 Mound Rd Ste 100 |
$3.97 | 4,246 | 4,151 |
|
Macomb Medical Clinic Pc
2405 E 14 Mile Rd |
$4.16 | 3,494 | 3,276 |
|
Fms Beaumont Health, Llc
44300 Dequindre Rd |
$19.84 | 1,118 | 159 |
|
St Peter Medical Center Pc
3058 Metropolitan Pkwy |
$21.14 | 718 | 671 |
|
Maple Crest Medical Plc
35450 Dequindre Rd |
$4.89 | 626 | 601 |
|
Labeed Sami Nouri
3058 Metropolitan Pkwy |
$32.21 | 561 | 533 |
|
David Basch Dpm Pc
39601 Van Dyke Ave |
$0.59 | 490 | 455 |
|
Khadhory Mercy Pllc
35200 Dequindre Rd Ste 600 |
$5.77 | 270 | 238 |
|
Toma & Yaldo Medical Center Pc
39150 Dequindre Rd Ste 200 |
$6.65 | 243 | 235 |
|
Get Well Urgent Care Sterling Heights Plc
2567 Metropolitan Pkwy |
$1.11 | 240 | 235 |
|
Michigan Kidney Consultants, P.C.
5280 Metropolitan Pkwy |
$48.82 | 178 | 115 |
|
Quang T Le
37450 Dequindre Rd |
$5.10 | 176 | 131 |
|
Pain Clinic Management Group, Pllc
35634 Dequindre Rd |
$1.13 | 153 | 149 |
|
Minimally Invasive Pain Specialists Pllc
9001 15 Mile Rd Ste C |
$0.99 | 153 | 150 |
|
Sterling Heights Urgent Care,P.L.L.C
37771 Schoenherr Rd |
$1.08 | 102 | 99 |
|
Elite Internal Medicine, Pc
34580 Dequindre Rd |
$3.50 | 94 | 91 |
|
Dr Kyle W Sundblad Pc
41400 Dequindre Rd |
$0.66 | 74 | 56 |
|
Mazen Alsaqa Md Pllc
1988 Long Meadow Dr |
$1.54 | 65 | 53 |
|
Associates In Family Practice Pllc
42755 Mound Rd |
$8.79 | 54 | 51 |
|
Forum Medical Clinic, Pc
43184 Dequindre Rd Ste 202 |
$4.91 | 40 | 37 |
|
Town Pediatric Clinic Pllc
3755 E. 15 Mile Road |
$0.47 | 34 | 27 |
|
Michigan Primary Care Pllc
41400 Dequindre Rd Ste 121 |
$5.41 | 29 | 25 |
|
Family Care Urgent Care Pllc
5843 17 Mile Rd |
$0.28 | 25 | 25 |
|
Skywalk Internal Medicine, Pc
44344 Dequindre Rd |
$1.67 | 15 | 15 |
|
Thaeer Sawa Md Pllc
35450 Dequindre Rd |
$1.00 | 14 | 14 |
|
Kuldip S. Deogun, Md, Pc
43145 Schoenherr Rd |
$0.83 | 13 | 13 |
|
Raja Lewis Md Pc
33164 Ryan Rd |
$0.11 | 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 Sterling Heights, MI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Sterling Heights, MI is $4.44 per claim, based on 29,333 claims from 29 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 Sterling Heights, MI?
There are 29 Medicaid providers offering Prescription Medications related services in Sterling Heights, MI according to public payment data.
What is the price range for Prescription Medications in Sterling Heights, MI?
Medicaid reimbursement for Prescription Medications in Sterling Heights, MI ranges from $0.11 to $48.82 per claim, with an average of $4.44. 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 Sterling Heights, MI
Office Visit
Avg $64.34
859,446 claims
Dental Cleaning & Exam
Avg $35.14
308,192 claims
Physical Therapy
Avg $31.69
256,428 claims
Blood Work & Lab Tests
Avg $5.34
163,292 claims
Vaccines & Immunizations
Avg $8.67
137,671 claims
Psychiatric Evaluation
Avg $63.83
123,170 claims
Ambulance Transport
Avg $93.94
109,353 claims
Dental Filling
Avg $110.14
72,607 claims