Average Medicaid Prescription Medications Payments
Typical Medicaid Prescription Medications reimbursement across 5,304 cities
Avg. Medicaid Paid
$28.35
Price Range
$0.00 β $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 |
|---|---|---|---|---|
| Port Royal, SC | $6.88 | $6.88 β $6.88 | 26 | 1 |
| Pierre, SD | $50.60 | $50.60 β $50.60 | 26 | 1 |
| Salem, UT | $0.00 | $0.00 β $0.00 | 26 | 1 |
| Nipomo, CA | $2.66 | $2.66 β $2.66 | 26 | 1 |
| Carriere, MS | $5.89 | $5.89 β $5.89 | 26 | 1 |
| Usaf Academy, CO | $0.00 | $0.00 β $0.00 | 26 | 1 |
| Lexington, NE | $30.72 | $30.72 β $30.72 | 26 | 1 |
| West Jefferson, NC | $1.68 | $1.68 β $1.68 | 26 | 1 |
| Lindsay, OK | $0.36 | $0.36 β $0.36 | 26 | 1 |
| Orr, MN | $0.46 | $0.46 β $0.46 | 26 | 1 |
| Knightstown, IN | $1.00 | $1.00 β $1.00 | 26 | 1 |
| Benton, LA | $0.57 | $0.57 β $0.57 | 26 | 1 |
| Pangburn, AR | $0.04 | $0.04 β $0.04 | 26 | 1 |
| Fort Johnson, LA | $1.43 | $1.43 β $1.43 | 26 | 1 |
| Hays, KS | $2.43 | $2.35 β $2.51 | 27 | 2 |
| Wynnewood, PA | $224.00 | $224.00 β $224.00 | 27 | 1 |
| Monticello, IN | $1.35 | $1.35 β $1.35 | 27 | 1 |
| Salem, IL | $0.00 | $0.00 β $0.00 | 27 | 1 |
| Lewisburg, PA | $3.02 | $3.02 β $3.02 | 27 | 1 |
| Mccamey, TX | $1.52 | $1.52 β $1.52 | 27 | 1 |
| Bradford, AR | $6.67 | $6.67 β $6.67 | 27 | 1 |
| Bloomsburg, PA | $0.00 | $0.00 β $0.00 | 27 | 1 |
| Lake Forest, IL | $3.65 | $3.10 β $4.34 | 27 | 2 |
| Ft Walton Beach, FL | $63.69 | $63.69 β $63.69 | 27 | 1 |
| Jamestown, OH | $0.11 | $0.11 β $0.11 | 27 | 1 |
| Lamont, CA | $0.00 | $0.00 β $0.00 | 27 | 2 |
| Fairfield, TX | $0.16 | $0.16 β $0.16 | 27 | 1 |
| Basalt, CO | $22.77 | $22.77 β $22.77 | 27 | 1 |
| Del Norte, CO | $0.00 | $0.00 β $0.00 | 27 | 1 |
| Cedar Hill, TX | $98.46 | $98.46 β $98.46 | 27 | 1 |
| Newman, CA | $8.61 | $8.61 β $8.61 | 27 | 1 |
| Sterling, MI | $0.58 | $0.58 β $0.58 | 27 | 1 |
| Avondale, PA | $1.18 | $1.18 β $1.18 | 27 | 1 |
| Cashiers, NC | $0.47 | $0.47 β $0.47 | 27 | 1 |
| Brookhaven, GA | $6.78 | $6.78 β $6.78 | 27 | 1 |
| Adamsville, TN | $0.31 | $0.27 β $0.35 | 27 | 2 |
| Aliso Viejo, CA | $0.06 | $0.06 β $0.06 | 28 | 1 |
| Langhorne, PA | $0.45 | $0.00 β $0.83 | 28 | 2 |
| Piqua, OH | $70.23 | $70.23 β $70.23 | 28 | 1 |
| Lutz, FL | $305.98 | $305.98 β $305.98 | 28 | 1 |
| Angier, NC | $1.14 | $1.14 β $1.14 | 28 | 1 |
| Silverthorne, CO | $0.00 | $0.00 β $0.00 | 28 | 1 |
| Pleasant Grove, UT | $4.54 | $4.54 β $4.54 | 28 | 1 |
| Mangonia Park, FL | $0.02 | $0.00 β $0.05 | 28 | 2 |
| San Fernando, CA | $10.71 | $0.00 β $21.41 | 28 | 2 |
| Newport, OR | $5.25 | $0.00 β $10.50 | 28 | 2 |
| Whitehall, OH | $0.00 | $0.00 β $0.00 | 28 | 1 |
| Uncasville, CT | $0.00 | $0.00 β $0.00 | 28 | 1 |
| El Reno, OK | $0.60 | $0.00 β $1.20 | 28 | 2 |
| Lenox, MA | $4.91 | $4.91 β $4.91 | 28 | 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.