J3375 Medicaid Rate by State

Injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg

24 state Medicaid programs publish a fee-for-service rate for J3375 (injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg), ranging from $0.12 in Idaho to $0.16 in California.

Every state, kept current

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This page shows one representative rate per state for J3375. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

24

Median % of Medicare

--

Rate range

$0.12 - $0.16

J3375 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$0.13----2026
Arizona$0.14----2026
California$0.16----2026
Connecticut$0.13----2025
District of Columbia$0.13--Not required2025
Idaho$0.12--Not required2026
Illinois$0.16----2026
Indiana$0.15----2025
Kansas$0.14----2026
Louisiana$0.14----2026
Michigan$0.14----2026
Minnesota$0.14----2026
Mississippi$0.16----2026
Montana$0.13----2026
Nebraska$0.14----2026
New Hampshire$0.15--Not required2026
New Jersey$0.15--Not required2026
Oklahoma$0.14----2026
Texas$0.13*----2025
Virginia$0.14----2026
Vermont$0.13----2026
Washington$0.14----2026
Wisconsin$0.14----2026
Wyoming$0.14----2026

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.

Related drugs codes

All 74 codes from J3000 to J3489 or every drugs code by number.

Frequently asked questions

How much does Medicaid pay for J3375?

24 state Medicaid programs publish a fee-for-service rate for J3375 (injection, vancomycin hydrochloride (tyzavan), not therapeutically equivalent to j3373, 10 mg), ranging from $0.12 in Idaho to $0.16 in California. The full table on this page lists every publishing state's current rate.

Which state pays the most for J3375?

California publishes the highest Medicaid rate for J3375 at $0.16. Idaho publishes the lowest at $0.12.

Does J3375 require prior authorization under Medicaid?

No publishing state flags J3375 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.