Based on public Medicaid payment data.

Average Medicaid Prescription Medications Payments in Worcester, MA: $32.41

Avg. Paid

$32.41

Range

$0.27 – $896.41

Total Claims

79,126

Providers

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 Worcester, MA

Provider	Avg. Paid	Claims	Patients
Umass Memorial Medical Center, Inc. 55 Lake Avenue	$16.53	37,529	29,961
Vhs Acquisition Subsidiary Number 7 Inc 123 Summer St	$5.28	22,932	18,046
James Celestin 123 Summer St	$16.12	4,268	3,747
Family Health Center Of Worcester, Inc. 26 Queen St	$0.53	2,881	2,874
Edward M. Kennedy Community Health Center, Inc 19 Tacoma St	$26.94	2,311	2,299
Antranig Kalaydjian 123 Summer St Ste 370	$11.37	1,879	1,806
Erica A Fullerton 119 Belmont Street	$82.72	1,292	1,257
Charles A Birbara 25 Oak Ave	$2.79	1,271	1,205
Physicians Dialysis Acquisitions Inc 19 Glennie St	$0.27	846	90
Maria S Dibner 123 Summer St	$896.41	655	509
Bryan Kun Hong 67 Belmont St	$875.88	583	554
Brad J Baker 67 Belmont Street	$548.44	477	456
William B Balcom 123 Summer Street	$6.19	360	352
Janice Flores-Lewis 5 Neponset St	$8.62	321	308
John T Hosey 5 Neponset St	$8.15	190	183
Gary R Keilson 123 Summer St	$596.36	175	130
Christina G Kane 55 Lake Ave N	$19.99	160	159
David C. Kim 123 Summer St Ste 370N	$15.80	137	134
Jonathan M Tisdell 123 Summer St Ste 660	$314.41	128	75
Joseph M Pugleasa 119 Belmont St	$8.52	106	100
Christopher Jay Vinton 59 Quinsigamond Ave	$4.14	84	65
Raymond S. Kagels 123 Summer St	$12.95	83	81
Chelsea A Fleck 119 Belmont Street	$81.17	62	61
Demian G Mousad 116 Belmont St Rm 34	$3.84	53	51
Christopher Leahy 123 Summer St	$5.71	44	43
Kimberly A. Brennan 123 Summer St	$3.83	40	37
Gary L. Peters 123 Summer Street	$5.03	39	39
Tony M Samaha 123 Summer St	$0.87	38	28
Caitlin Johnson Pasquale 55 Lake Ave N	$1.68	33	26
William Edward Traverse 119 Belmont St	$3.34	28	27
George B Peters 281 Lincoln St	$571.06	25	18
Carolyn A Benson 123 Summer St Ste 230S	$815.45	23	12
Ilsa Y Grunder 55 Lake Ave N	$1.46	21	17
Bradley K Schaffer 123 Summer St	$7.22	14	14
Kwame Okyere Amponsah 10 Winthrop St Ste 312	$92.25	13	13
Edison Tsui 5 Neponset St	$1.44	13	13
Jonathan W. Ponte 123 Summer St	$7.23	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 Worcester, MA?

Based on public Medicaid payment data, the average Medicaid reimbursement for Prescription Medications in Worcester, MA is $32.41 per claim, based on 79,126 claims from 37 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 Worcester, MA?

There are 37 Medicaid providers offering Prescription Medications related services in Worcester, MA according to public payment data.

What is the price range for Prescription Medications in Worcester, MA?

Medicaid reimbursement for Prescription Medications in Worcester, MA ranges from $0.27 to $896.41 per claim, with an average of $32.41. Private insurance and self-pay costs are typically higher than these Medicaid rates.

Average Medicaid Prescription Medications Payments in Worcester, MA: $32.41

Providers Offering Prescription Medications in Worcester, MA

What to Expect: Prescription Medications

Cost Components

Frequently Asked Questions

Prescription Medications in Other Cities

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Milwaukee, WI

Washington, DC

Los Angeles, CA

Louisville, KY

New York, NY

San Diego, CA

Tucson, AZ

Other Procedures in Worcester, MA

Substance Abuse Treatment

Office Visit

Psychiatric Evaluation

Non-Emergency Medical Transportation

Home Health Visit

Dental Cleaning & Exam

Blood Work & Lab Tests

Behavioral & Mental Health Therapy