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 |
|---|---|---|---|---|
| Lindsay, CA | $7.66 | $1.75 β $17.64 | 94 | 2 |
| Clinton, IN | $3.94 | $0.75 β $4.55 | 94 | 2 |
| Burgaw, NC | $29.83 | $28.50 β $31.36 | 94 | 3 |
| Etowah, TN | $0.39 | $0.00 β $0.56 | 94 | 2 |
| Newton, KS | $11.39 | $2.64 β $71.94 | 95 | 2 |
| Dunlap, TN | $0.45 | $0.07 β $0.54 | 95 | 2 |
| Chatham, LA | $0.00 | $0.00 β $0.00 | 95 | 3 |
| Oneill, NE | $1.59 | $1.59 β $1.59 | 96 | 1 |
| Yorktown Heights, NY | $5.52 | $0.17 β $10.05 | 96 | 2 |
| Pigeon Forge, TN | $0.63 | $0.63 β $0.63 | 96 | 1 |
| Peapack, NJ | $41.39 | $41.39 β $41.39 | 96 | 1 |
| Mc Kee, KY | $6.48 | $1.81 β $9.09 | 97 | 4 |
| Spencer, TN | $0.00 | $0.00 β $0.00 | 97 | 1 |
| Paulding, OH | $0.20 | $0.20 β $0.20 | 97 | 1 |
| Pioneer, LA | $0.01 | $0.01 β $0.01 | 97 | 1 |
| Bath, NY | $0.00 | $0.00 β $0.00 | 98 | 1 |
| Rehoboth Beach, DE | $3.60 | $3.55 β $3.94 | 98 | 2 |
| Isle Of Palms, SC | $0.35 | $0.35 β $0.35 | 98 | 1 |
| Scarbro, WV | $21.60 | $21.60 β $21.60 | 98 | 1 |
| Florala, AL | $0.48 | $0.48 β $0.48 | 98 | 1 |
| Frankewing, TN | $0.14 | $0.14 β $0.14 | 98 | 1 |
| Christopher, IL | $0.00 | $0.00 β $0.00 | 99 | 1 |
| Chadbourn, NC | $0.01 | $0.00 β $0.08 | 99 | 2 |
| Springville, AL | $8.86 | $8.86 β $8.86 | 99 | 1 |
| Kentwood, LA | $0.22 | $0.00 β $0.26 | 99 | 2 |
| Round Rock, TX | $1.79 | $0.05 β $5.39 | 100 | 4 |
| Abington, PA | $0.02 | $0.02 β $0.02 | 100 | 1 |
| Bastrop, TX | $0.20 | $0.02 β $0.22 | 100 | 2 |
| Coppell, TX | $0.05 | $0.00 β $0.06 | 100 | 2 |
| Inverness, FL | $11.20 | $0.00 β $91.12 | 100 | 4 |
| Weddington, NC | $167.85 | $167.85 β $167.85 | 100 | 1 |
| Othello, WA | $1.99 | $0.74 β $8.54 | 100 | 2 |
| Washington, IA | $0.00 | $0.00 β $0.00 | 100 | 2 |
| Eufaula, OK | $4.35 | $0.00 β $5.00 | 100 | 2 |
| Sunnyvale, TX | $11.43 | $11.43 β $11.43 | 100 | 1 |
| Nancy, KY | $0.89 | $0.88 β $0.91 | 100 | 2 |
| Twinsburg, OH | $8.02 | $0.00 β $62.34 | 101 | 2 |
| Castle Pines, CO | $0.23 | $0.22 β $0.25 | 101 | 2 |
| Smithville, TX | $2.17 | $2.17 β $2.17 | 101 | 1 |
| North Branch, MN | $11.24 | $11.24 β $11.24 | 101 | 1 |
| Sheridan, MI | $0.00 | $0.00 β $0.00 | 101 | 1 |
| Whitesville, WV | $4.77 | $4.77 β $4.77 | 101 | 1 |
| Shallotte, NC | $4.70 | $3.49 β $5.99 | 102 | 3 |
| Holly Springs, NC | $26.60 | $0.00 β $35.58 | 102 | 3 |
| Bellbrook, OH | $55.72 | $0.00 β $64.59 | 102 | 2 |
| Middlebury, IN | $0.65 | $0.65 β $0.65 | 102 | 1 |
| Stratford, OK | $6.43 | $6.43 β $6.43 | 102 | 1 |
| Alturas, CA | $10.55 | $10.55 β $10.55 | 102 | 1 |
| Granite Falls, NC | $9.73 | $4.68 β $14.30 | 103 | 3 |
| Cedartown, GA | $0.63 | $0.35 β $0.73 | 103 | 2 |
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.