S5000
Prescription drug, generic
Prescription drug, generic is the #474 most-billed Medicaid procedure code, with $198.5M in payments across 2.9M claims from 2018–2024. The national median cost per claim is $7.47. Costs vary widely — the 90th percentile is $43.69 per claim, 5.8× the median.
Total Paid
$198.5M
0.02% of all spending
Total Claims
2.9M
Providers
275
Avg Cost/Claim
$69
National Cost Distribution
How much do providers bill per claim for S5000? Based on 225 providers billing this code nationally.
Median
$7.47
Average
$24.25
Std Dev
$60.22
Max
$710.86
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.18 and $23.47 per claim for this code.
90% bill between $3.54 and $43.69.
Top 1% bill above $227.74.
About This Procedure
HCPCS code S5000 (Prescription drug, generic) was billed by 275 providers across 2.9M claims, totaling $198.5M in Medicaid payments from 2018–2024. This code was used for 1.0M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.47
Providers Billing
225
National Spending
$198.5M
Avg/Median Ratio
3.25×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for S5000
| # | Provider | Total Paid |
|---|---|---|
| 1 | Brightview Llc Cincinnati, OH · Internal Medicine Addiction Medicine | $105.1M |
| 2 | Sunrise Treatment Center, Llc Cincinnati, OH · Clinic/Center, Adult Mental Health | $40.0M |
| 3 | 1043277759 | $7.1M |
| 4 | 1205188588 | $6.5M |
| 5 | County Of San Diego San Diego, CA · Public Health or Welfare | $5.7M |
| 6 | 1407115298 | $3.8M |
| 7 | County Of Sacramento Sacramento, CA · Community/Behavioral Health | $3.3M |
| 8 | 1366992224 | $2.5M |
| 9 | County Of Riverside Riverside, CA · Community/Behavioral Health | $2.3M |
| 10 | County Of Ventura Oxnard, CA · Community/Behavioral Health | $1.9M |
| 11 | Santa Barbara County Auditor Santa Barbara, CA · Psychologist | $1.6M |
| 12 | Department Of Behavioral Health Fresno, CA · Social Worker, Clinical | $1.5M |
| 13 | 1881957587 | $1.5M |
| 14 | San Joaquin Behavioral Health Services Stockton, CA · Counselor, Addiction (Substance Use Disorder) | $1.2M |
| 15 | City & County Of San Francisco San Francisco, CA · Community/Behavioral Health | $1.1M |
| 16 | County Of Kern Bakersfield, CA · Clinic/Center, Adult Mental Health | $1.1M |
| 17 | County Of Santa Clara San Jose, CA · Clinic/Center Methadone Clinic | $992K |
| 18 | 1841550696 | $969K |
| 19 | Los Angeles County Department Of Public Health Alhambra, CA · Public Health or Welfare | $836K |
| 20 | County Of San Bernardino San Bernardino, CA · Clinic/Center Rehabilitation Substance Use Disorder | $796K |
Showing top 20 of 275 providers billing this code