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 |
|---|---|---|---|---|
| Henry, TN | $0.61 | $0.61 β $0.61 | 103 | 1 |
| Wewahitchka, FL | $0.81 | $0.81 β $0.81 | 104 | 1 |
| Le Mars, IA | $12.65 | $12.65 β $12.65 | 104 | 1 |
| Taylor, AR | $0.44 | $0.44 β $0.44 | 104 | 1 |
| Walsenburg, CO | $0.43 | $0.00 β $0.67 | 105 | 3 |
| Port St Joe, FL | $22.12 | $18.83 β $26.03 | 105 | 2 |
| Fountain Hills, AZ | $0.00 | $0.00 β $0.00 | 105 | 1 |
| Creighton, NE | $1.11 | $1.11 β $1.11 | 105 | 1 |
| Durand, WI | $0.84 | $0.84 β $0.84 | 106 | 1 |
| Guilford, CT | $12.72 | $12.72 β $12.72 | 106 | 1 |
| Shoreview, MN | $13.84 | $13.84 β $13.84 | 106 | 1 |
| Clinton, TN | $13.19 | $3.69 β $22.79 | 106 | 3 |
| Farmingdale, NY | $1.57 | $1.57 β $1.57 | 106 | 1 |
| Denver, NC | $2.96 | $0.21 β $6.15 | 106 | 2 |
| Hugo, OK | $6.40 | $0.00 β $10.50 | 106 | 4 |
| Montour Falls, NY | $0.01 | $0.01 β $0.01 | 106 | 1 |
| Emporia, KS | $0.99 | $0.00 β $2.87 | 107 | 3 |
| Moundsville, WV | $36.80 | $36.80 β $36.80 | 107 | 1 |
| Aulander, NC | $0.34 | $0.34 β $0.34 | 107 | 1 |
| Georgetown, OH | $0.07 | $0.06 β $0.08 | 108 | 2 |
| Metuchen, NJ | $5.88 | $0.10 β $8.20 | 108 | 2 |
| Cranston, RI | $2.01 | $1.97 β $2.20 | 108 | 2 |
| Eufaula, AL | $0.83 | $0.81 β $0.89 | 108 | 3 |
| Washington, IL | $1.13 | $1.13 β $1.13 | 108 | 1 |
| Corona Del Mar, CA | $33.37 | $33.37 β $33.37 | 108 | 1 |
| Rockville, IN | $0.82 | $0.82 β $0.82 | 109 | 1 |
| Granite Falls, MN | $43.80 | $43.80 β $43.80 | 109 | 1 |
| Catlettsburg, KY | $9.47 | $9.37 β $9.49 | 109 | 2 |
| Lunenburg, VA | $20.94 | $20.94 β $20.94 | 109 | 1 |
| Decatur, TX | $2.59 | $2.59 β $2.59 | 110 | 1 |
| Bells, TN | $1.38 | $1.38 β $1.38 | 110 | 1 |
| Austin, MN | $0.51 | $0.00 β $1.32 | 111 | 5 |
| Anthem, AZ | $0.34 | $0.34 β $0.34 | 111 | 1 |
| Murphy, NC | $5.05 | $0.07 β $36.91 | 111 | 2 |
| Friendship, WI | $0.13 | $0.13 β $0.13 | 111 | 1 |
| Society Hill, SC | $2.92 | $2.75 β $4.13 | 111 | 2 |
| Shellman, GA | $0.42 | $0.42 β $0.42 | 111 | 1 |
| Pella, IA | $1.30 | $0.42 β $5.43 | 112 | 3 |
| Fairhope, AL | $12.84 | $0.00 β $24.87 | 112 | 3 |
| Lonoke, AR | $2.77 | $0.00 β $5.77 | 112 | 3 |
| Hiram, GA | $4.11 | $1.20 β $13.73 | 112 | 2 |
| Notasulga, AL | $4.65 | $4.65 β $4.65 | 112 | 1 |
| New Windsor, NY | $5.86 | $1.22 β $9.80 | 113 | 3 |
| North Tonawanda, NY | $0.00 | $0.00 β $0.00 | 113 | 1 |
| Leavenworth, KS | $0.59 | $0.00 β $0.93 | 113 | 2 |
| Deltona, FL | $0.38 | $0.38 β $0.38 | 113 | 1 |
| Newington, CT | $10.32 | $10.32 β $10.32 | 113 | 1 |
| Foster, KY | $7.75 | $7.75 β $7.75 | 113 | 1 |
| Westfield, NY | $0.03 | $0.00 β $0.04 | 113 | 2 |
| Hayesville, NC | $1.97 | $0.73 β $4.24 | 113 | 3 |
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.