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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
Kellogg, ID $3.92 $3.92 – $3.92 36 1
Huntington Station, NY $0.69 $0.69 – $0.69 36 1
Germantown, OH $0.70 $0.70 – $0.70 36 1
Glen Ellyn, IL $0.30 $0.30 – $0.30 36 1
Aberdeen, NC $2.07 $2.07 – $2.07 36 1
Whitehall, MT $3.28 $3.28 – $3.28 36 1
Crisfield, MD $0.03 $0.03 – $0.03 36 1
Dawson, GA $0.00 $0.00 – $0.00 36 1
Frostburg, MD $1.68 $1.68 – $1.68 36 1
Madisonville, TX $1.13 $1.13 – $1.13 36 1
Indian Head, MD $5.69 $5.69 – $5.69 36 1
Thief River Falls, MN $19.68 $19.68 – $19.68 37 1
Latham, NY $18.26 $18.26 – $18.26 37 1
West Orange, NJ $81.35 $81.35 – $81.35 37 1
Elmendorf Afb, AK $51.32 $51.32 – $51.32 37 1
Crosby, MN $18.49 $18.49 – $18.49 37 1
White City, OR $9.87 $9.87 – $9.87 37 1
Roosevelt, NY $57.54 $57.54 – $57.54 37 1
Plains, MT $0.43 $0.43 – $0.43 37 1
Saint Johnsbury, VT $1,084 $1,084 – $1,084 37 1
Colmar Manor, MD $0.07 $0.07 – $0.07 37 1
Chestertown, MD $1.29 $1.29 – $1.29 38 1
Warsaw, IN $0.47 $0.00 – $0.74 38 2
Largo, FL $221.80 $0.00 – $324.17 38 2
Bryn Mawr, PA $0.00 $0.00 – $0.00 38 1
Aguada, PR $0.00 $0.00 – $0.00 38 2
Deer Park, NY $0.08 $0.08 – $0.08 38 1
Glenville, WV $41.19 $2.16 – $101.05 38 2
Allendale, SC $25.85 $25.85 – $25.85 38 1
Inarajan, GU $85.50 $85.50 – $85.50 38 1
Tanner, AL $0.06 $0.02 – $0.13 38 2
Lenore, WV $51.19 $51.19 – $51.19 38 1
Jayuya, PR $0.04 $0.04 – $0.04 39 1
Weber City, VA $17.15 $17.15 – $17.15 39 1
Zebulon, NC $0.03 $0.00 – $0.05 39 2
Lutcher, LA $0.17 $0.17 – $0.17 39 1
Pinetops, NC $0.68 $0.68 – $0.68 39 1
Perry, GA $0.28 $0.28 – $0.28 39 1
North Fond Du Lac, WI $83.31 $83.31 – $83.31 39 1
Va Beach, VA $0.54 $0.36 – $0.62 39 2
Tollesboro, KY $1.51 $1.51 – $1.51 39 1
Kenly, NC $2.76 $2.76 – $2.76 39 1
Portland, TX $0.22 $0.00 – $0.62 39 2
Toluca Lake, CA $0.00 $0.00 – $0.00 39 1
Post, TX $0.97 $0.97 – $0.97 39 1
Rehobeth, AL $0.35 $0.35 – $0.35 39 1
Sebastopol, CA $15.50 $15.50 – $15.50 40 1
Keizer, OR $0.41 $0.00 – $1.16 40 2
Warrensburg, MO $0.00 $0.00 – $0.00 40 1
Ripon, CA $10.22 $10.22 – $10.22 40 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.