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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
Fort Stewart, GA $22.47 $0.78 – $90.64 58 2
Leland, NC $1.34 $0.32 – $4.84 58 2
Pinellas Park, FL $6.13 $0.41 – $19.92 58 2
Wadsworth, OH $0.09 $0.00 – $0.11 58 2
Streator, IL $67.52 $67.52 – $67.52 58 1
Des Arc, AR $0.00 $0.00 – $0.00 58 1
Grand Bay, AL $0.60 $0.00 – $0.92 58 4
San Joaquin, CA $0.00 $0.00 – $0.00 58 1
Bell, CA $0.00 $0.00 – $0.00 59 1
Hamilton, MT $0.93 $0.00 – $1.66 59 2
North Little Rock, AR $0.12 $0.12 – $0.12 59 1
Burgettstown, PA $0.05 $0.05 – $0.05 59 1
Rockaway, NJ $5.64 $5.64 – $5.64 59 1
Boys Town, NE $1.10 $0.39 – $1.65 59 2
Mexia, TX $18.93 $18.93 – $18.93 59 1
Sebree, KY $0.39 $0.35 – $0.44 59 2
Fort Gordon, GA $0.40 $0.40 – $0.40 60 1
Beaver Falls, PA $6.91 $6.91 – $6.91 60 1
Lecanto, FL $0.29 $0.29 – $0.29 60 1
Carrollton, OH $0.01 $0.01 – $0.01 60 1
Sylvan Lake, MI $1.70 $1.70 – $1.70 60 1
Virginia Bch, VA $43.73 $1.06 – $81.07 60 2
Bladenboro, NC $20.99 $20.99 – $20.99 60 1
Solana Beach, CA $62.50 $62.50 – $62.50 60 1
Crossville, AL $2.90 $2.90 – $2.90 60 1
Basile, LA $6.00 $6.00 – $6.00 60 1
St Johnsbury, VT $30.32 $30.32 – $30.32 61 1
Benton, IL $2.29 $2.29 – $2.29 61 1
Hackberry, LA $0.76 $0.76 – $0.76 61 1
Avenel, NJ $0.53 $0.53 – $0.53 61 1
Lyles, TN $0.20 $0.20 – $0.20 61 1
Southside, AL $0.77 $0.77 – $0.77 61 1
Haslet, TX $1.64 $1.64 – $1.64 61 1
Pottsville, PA $3.25 $3.25 – $3.25 62 1
Peekskill, NY $0.38 $0.38 – $0.38 62 1
Onarga, IL $0.00 $0.00 – $0.00 62 1
Immokalee, FL $12.32 $1.74 – $52.18 62 2
Nellis Afb, NV $0.12 $0.00 – $0.61 62 3
Dunwoody, GA $0.39 $0.39 – $0.39 62 1
Redondo Beach, CA $9.30 $9.30 – $9.30 63 1
Fort Branch, IN $0.00 $0.00 – $0.00 63 1
Algonquin, IL $9.92 $6.50 – $11.09 63 2
Canton, GA $65.53 $0.19 – $85.95 63 2
Balch Springs, TX $0.78 $0.09 – $1.00 63 2
Sharon, PA $0.02 $0.00 – $0.08 64 3
Barnesville, OH $0.00 $0.00 – $0.00 64 1
Johnson City, NY $227.56 $0.83 – $966.99 64 3
South Salt Lake, UT $0.00 $0.00 – $0.00 64 1
Morrow, GA $1.14 $1.14 – $1.14 64 1
Cohoes, NY $4.40 $4.40 – $4.40 64 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.