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Based on public Medicaid payment data.

Average Medicaid Prescription Medications Payments

Typical Medicaid Prescription Medications reimbursement across 5,304 cities

Avg. Medicaid Paid

$28.35

Price Range

$0.00 – $2,704

Total Claims

61.1M

Cities

5304

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.

About This Procedure

Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Ocoee, FL $0.00 $0.00 – $0.00 12 1
Missouri City, TX $21.81 $21.81 – $21.81 12 1
Snow Hill, NC $41.48 $41.48 – $41.48 12 1
Berwyn, IL $21.18 $21.18 – $21.18 12 1
Doniphan, MO $0.00 $0.00 – $0.00 12 1
Celina, OH $0.00 $0.00 – $0.00 12 1
St Albans, VT $0.00 $0.00 – $0.00 12 1
Willow Grove, PA $6.98 $6.98 – $6.98 12 1
Girard, OH $0.12 $0.12 – $0.12 12 1
Gilmer, TX $6.73 $6.73 – $6.73 12 1
Newton, IA $1.50 $1.50 – $1.50 12 1
Castaic, CA $5.80 $5.80 – $5.80 12 1
Ebensburg, PA $0.00 $0.00 – $0.00 12 1
Coffeyville, KS $1.25 $1.25 – $1.25 12 1
Pensacola Beach, FL $3.39 $3.39 – $3.39 12 1
Towanda, PA $0.00 $0.00 – $0.00 12 1
Hazleton, PA $0.00 $0.00 – $0.00 12 1
Highland, UT $0.00 $0.00 – $0.00 12 1
Danbury, NC $10.57 $10.57 – $10.57 12 1
Saint Stephen, SC $5.24 $5.24 – $5.24 12 1
Elizabeth, WV $102.59 $102.59 – $102.59 12 1
Wilton, CT $0.06 $0.06 – $0.06 12 1
Pueblo West, CO $1.20 $1.20 – $1.20 12 1
South Daytona, FL $0.00 $0.00 – $0.00 12 1
Taylor, TX $1.03 $1.03 – $1.03 12 1
Patten, ME $1.93 $1.93 – $1.93 12 1
Long Prairie, MN $21.22 $21.22 – $21.22 12 1
Weston, FL $0.90 $0.90 – $0.90 12 1
Salida, CO $0.00 $0.00 – $0.00 12 1
Lavalette, WV $0.15 $0.15 – $0.15 12 1
Akron, CO $0.42 $0.42 – $0.42 12 1
Harlan, IA $0.00 $0.00 – $0.00 12 1
Saint Albans, WV $89.39 $89.39 – $89.39 12 1
Eddyville, KY $0.13 $0.13 – $0.13 12 1
Stigler, OK $0.32 $0.32 – $0.32 12 1
Philipsburg, PA $0.00 $0.00 – $0.00 12 1
Burlington, KY $7.12 $7.12 – $7.12 12 1
Salem, MO $0.03 $0.03 – $0.03 12 1
Bellerose, NY $6.35 $6.35 – $6.35 12 1
Monument, CO $412.00 $412.00 – $412.00 12 1
Wewoka, OK $0.00 $0.00 – $0.00 12 1
Hollidaysburg, PA $3.57 $3.57 – $3.57 12 1
Collegeville, PA $0.00 $0.00 – $0.00 12 1
Yellow Springs, OH $7.54 $7.54 – $7.54 12 1
Pauls Valley, OK $0.61 $0.61 – $0.61 12 1
Parkland, FL $0.00 $0.00 – $0.00 12 1
Gore, OK $6.69 $6.69 – $6.69 12 1
Mariposa, CA $5.08 $5.08 – $5.08 12 1
Natick, MA $7.10 $7.10 – $7.10 12 1
Odenton, MD $0.24 $0.24 – $0.24 12 1

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

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 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.