Average Medicaid Prescription Medications Payments in Sumter, SC: $6.12
Avg. Paid
$6.12
Range
$0.21 – $81.25
Total Claims
45,573
Providers
34
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 Sumter, SC
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Prisma Health-Midlands
129 N. Washington Street |
$0.84 | 22,345 | 14,162 |
|
Total Renal Care Inc
418 Broad St |
$0.21 | 5,193 | 617 |
|
William Scott Kellogg
1105 N Lafayette Dr |
$0.73 | 3,434 | 1,418 |
|
State Of South Carolina
407 N Salem Ave |
$14.81 | 2,220 | 2,205 |
|
Edward Julian Meyers
325 Broad St Ste 100 |
$1.16 | 2,059 | 1,789 |
|
James M Durant
237 Church St |
$1.77 | 1,794 | 1,442 |
|
Joel Janeen-Belton Snipe
319 N Main St |
$78.01 | 1,672 | 1,641 |
|
Danny H. Ford
100 N Sumter St |
$2.80 | 1,615 | 1,413 |
|
Ryan Corbin Zitzke
100 N Sumter St |
$4.75 | 735 | 711 |
|
Timothy L Key
237 Church St |
$1.86 | 507 | 373 |
|
Kayla Knopf Boykin
370 South Pike West |
$80.95 | 447 | 443 |
|
Carrie Elliott Hoshour
325 Broad St |
$1.38 | 444 | 403 |
|
Giselle Terry-Ann Chandler
370 South Pike West |
$75.56 | 437 | 436 |
|
Kurt T. Stroebel
100 N Sumter St |
$4.76 | 395 | 380 |
|
Fresenius Medical Care Cna Kidney Centers, Llc
615 W Wesmark Blvd |
$0.85 | 325 | 179 |
|
Arvie Cecil Collins
115 N Sumter St |
$4.54 | 245 | 243 |
|
Matthew J Furman
215 W Hampton Ave |
$5.19 | 223 | 182 |
|
Barbara Jean Epps
325 Broad St Ste 100 |
$0.86 | 216 | 206 |
|
Grace Wielicki Couch
325 Broad St |
$1.05 | 200 | 187 |
|
Michele Renee Easler
237 Church St |
$1.31 | 196 | 149 |
|
Billy Wayne Clowney
1105 N Lafayette Dr |
$0.80 | 183 | 100 |
|
Fresenius Medical Care Cna Kidney Centers, Llc
520 Physicians Ln |
$1.97 | 167 | 80 |
|
David Russell Trigg
325 Broad St |
$0.58 | 103 | 93 |
|
Scarlett Manchin
540 Physicians Ln |
$3.15 | 96 | 78 |
|
Wendy L Marean
10 Miller Rd |
$1.02 | 75 | 60 |
|
Thomas Lawman Lucas
325 Broad St |
$0.65 | 57 | 55 |
|
Jill Braddy Mcleod
115 N Sumter St Ste 200 |
$7.60 | 52 | 52 |
|
John Mark Mitchiner
237 Church St |
$1.24 | 48 | 39 |
|
Lisa Jeffus Smith
1761 Pinewood Road |
$0.82 | 24 | 24 |
|
Erryn C Provencher
674 W Liberty St |
$1.05 | 18 | 15 |
|
Mollie Williams
370 S Pike W |
$73.84 | 12 | 12 |
|
Holly Scott Barnes
370 S Pike W |
$81.25 | 12 | 12 |
|
Mark A Hucks
115 N Sumter St |
$8.49 | 12 | 12 |
|
Triz Van Smith
115 N Sumter St |
$23.50 | 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 Sumter, SC?
Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Sumter, SC is $6.12 per claim, based on 45,573 claims from 34 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 Sumter, SC?
There are 34 Medicaid providers offering Prescription Medications related services in Sumter, SC according to public payment data.
What is the price range for Prescription Medications in Sumter, SC?
Medicaid reimbursement for Prescription Medications in Sumter, SC ranges from $0.21 to $81.25 per claim, with an average of $6.12. 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
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Louisville, KY
Avg $31.67
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New York, NY
Avg $40.26
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San Diego, CA
Avg $27.34
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Tucson, AZ
Avg $24.34
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Other Procedures in Sumter, SC
Office Visit
Avg $76.88
592,225 claims
Blood Work & Lab Tests
Avg $12.51
300,851 claims
Dental Cleaning & Exam
Avg $34.02
167,492 claims
Vaccines & Immunizations
Avg $19.55
162,920 claims
Emergency Room Visit
Avg $38.43
157,791 claims
Urinalysis & Urine Tests
Avg $21.60
129,948 claims
Speech Therapy
Avg $38.90
125,766 claims
Home Health Visit
Avg $44.33
116,753 claims