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