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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
Truckee, CA $1.83 $0.48 – $4.38 78 2
Richfield, MN $81.44 $0.00 – $105.87 78 2
Waconia, MN $1.21 $1.21 – $1.21 78 1
Rickman, TN $1.42 $1.42 – $1.42 78 1
Erwin, NC $0.03 $0.01 – $0.10 78 2
Lucas, OH $71.94 $71.94 – $71.94 78 1
Butler, GA $0.04 $0.04 – $0.04 78 1
Gun Barrel City, TX $4.60 $4.36 – $5.91 79 2
Boscobel, WI $0.46 $0.01 – $1.36 79 2
Winona, MN $11.45 $1.01 – $28.50 79 2
Slc, UT $0.00 $0.00 – $0.00 79 1
Moultrie, GA $0.33 $0.18 – $1.20 79 2
Tishomingo, OK $1.78 $1.21 – $2.24 79 3
Burns, OR $0.00 $0.00 – $0.00 79 1
West Sacramento, CA $316.48 $3.60 – $372.52 79 2
Eastville, VA $48.48 $48.48 – $48.48 79 1
Mc Donald, TN $1.51 $1.51 – $1.51 79 1
Dundee, FL $2.23 $2.23 – $2.23 80 1
Happy Valley, OR $2.08 $2.08 – $2.08 80 1
Eglin Afb, FL $1.87 $0.00 – $5.50 80 4
Lackland A F B, TX $34.57 $6.74 – $65.32 80 2
Melvindale, MI $0.17 $0.17 – $0.17 80 1
Riviera Beach, FL $57.27 $57.27 – $57.27 81 1
Apopka, FL $0.16 $0.00 – $0.30 81 3
Upland, PA $0.02 $0.00 – $0.02 81 2
Edenton, NC $4.05 $0.00 – $6.03 81 3
Byron Center, MI $7.82 $7.82 – $7.82 81 1
Summit, IL $18.13 $6.05 – $34.00 81 2
Saint Gabriel, LA $17.14 $5.62 – $22.59 81 2
Riceville, TN $0.71 $0.71 – $0.71 81 1
Troy, MO $0.36 $0.00 – $1.18 82 2
Bishop, CA $28.22 $28.22 – $28.22 82 1
Orange City, FL $38.86 $3.75 – $65.02 82 2
Cooper City, FL $0.90 $0.90 – $0.90 82 1
Nokesville, VA $0.10 $0.10 – $0.10 82 1
Troutdale, VA $0.08 $0.08 – $0.08 82 1
Englewood, TN $28.44 $0.00 – $33.80 82 2
Bennetsville, SC $0.55 $0.55 – $0.55 82 1
Blountstown, FL $0.05 $0.00 – $0.10 83 3
Wabash, IN $28.00 $28.00 – $28.00 83 1
Siletz, OR $17.53 $17.53 – $17.53 83 1
Lompoc, CA $3.76 $0.00 – $5.20 84 3
Grand Prairie, TX $0.24 $0.00 – $1.07 84 4
Rushville, IN $0.00 $0.00 – $0.00 84 1
Sparta, NJ $70.31 $70.31 – $70.31 84 1
Cayce, SC $83.53 $69.54 – $86.33 84 2
Daniel Island, SC $0.97 $0.97 – $0.97 84 1
Greenville, DE $0.10 $0.10 – $0.10 84 1
Rochelle Park, NJ $0.00 $0.00 – $0.00 85 1
Trenton, GA $0.83 $0.83 – $0.83 85 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.