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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
Wofford Heights, CA $3.03 $3.03 – $3.03 47 1
Altoona, IA $0.00 $0.00 – $0.00 47 1
Alvin, TX $0.62 $0.00 – $1.39 47 2
Johnstown, CO $0.10 $0.10 – $0.10 47 1
Williston, ND $0.38 $0.28 – $0.45 47 2
Woodinville, WA $1,005 $1,005 – $1,005 47 1
White Hall, WV $1.02 $1.02 – $1.02 47 1
Elkview, WV $0.43 $0.43 – $0.43 47 1
Gooding, ID $1.64 $1.64 – $1.64 48 1
Denver City, TX $7.80 $7.80 – $7.80 48 1
Hot Springs Village, AR $85.06 $85.06 – $85.06 48 1
Mountain View, AR $0.55 $0.55 – $0.55 48 1
Lake Placid, FL $0.00 $0.00 – $0.00 48 1
Clarion, IA $9.99 $9.99 – $9.99 48 1
Springfield, KY $0.87 $0.82 – $1.02 48 2
Camuy, PR $0.00 $0.00 – $0.00 48 1
Vilonia, AR $0.00 $0.00 – $0.00 48 1
Fairview, OK $3.48 $3.48 – $3.48 49 1
Ridgeland, SC $21.23 $21.23 – $21.23 49 1
Grand Rapids, MN $0.36 $0.36 – $0.37 49 2
Chevy Chase, MD $50.06 $0.66 – $151.94 49 2
League City, TX $9.62 $2.21 – $12.29 49 2
Red Cloud, NE $0.34 $0.34 – $0.34 49 1
Saint Charles, IL $8.86 $8.86 – $8.86 49 1
Savoy, IL $0.00 $0.00 – $0.00 49 1
Altavista, VA $79.60 $79.60 – $79.60 49 1
Childersburg, AL $0.78 $0.76 – $0.82 49 2
Morris, IL $0.77 $0.77 – $0.77 50 1
Humacao, PR $0.30 $0.30 – $0.30 50 1
Tomball, TX $6.51 $0.17 – $8.51 50 2
Punxsutawney, PA $0.00 $0.00 – $0.00 50 1
Winnsboro, SC $13.56 $0.00 – $18.32 50 2
Concord Twp, OH $4.07 $0.07 – $5.48 50 2
Worthington, IN $0.85 $0.85 – $0.85 50 1
Hamburg, IA $0.00 $0.00 – $0.00 50 1
North Garden, VA $130.47 $130.47 – $130.47 50 1
Oglethorpe, GA $0.64 $0.64 – $0.64 50 1
Woodville, AL $0.00 $0.00 – $0.00 50 1
Mcdaniels, KY $0.93 $0.93 – $0.93 50 1
Lebanon, OR $0.00 $0.00 – $0.00 51 1
Trinity, FL $2.15 $0.00 – $4.59 51 3
Redwood Falls, MN $0.00 $0.00 – $0.00 51 2
Woodward, OK $0.89 $0.71 – $1.15 51 2
Woodmere, NY $131.59 $131.59 – $131.59 51 1
Menasha, WI $1.23 $1.23 – $1.23 51 1
Mc Kees Rocks, PA $0.30 $0.30 – $0.30 51 1
Malad City, ID $0.21 $0.21 – $0.21 51 1
Jasper, AR $0.97 $0.97 – $0.97 51 1
Rural Retreat, VA $0.76 $0.76 – $0.76 51 1
Sherman, MS $0.50 $0.50 – $0.50 51 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.