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