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 |
|---|---|---|---|---|
| Heber City, UT | $9.99 | $0.00 β $11.35 | 125 | 2 |
| Wheaton, IL | $1,042 | $922.03 β $1,113 | 126 | 3 |
| Waxhaw, NC | $870.36 | $870.36 β $870.36 | 126 | 1 |
| De Kalb, TX | $0.55 | $0.55 β $0.55 | 126 | 1 |
| Jackson, LA | $0.71 | $0.71 β $0.71 | 126 | 1 |
| Clark, NJ | $4.23 | $4.23 β $4.23 | 127 | 1 |
| Fairhaven, MA | $0.93 | $0.93 β $0.93 | 127 | 1 |
| Jamestown, ND | $55.70 | $55.70 β $55.70 | 127 | 1 |
| Port Matilda, PA | $0.00 | $0.00 β $0.00 | 128 | 1 |
| Pigeon, MI | $0.00 | $0.00 β $0.00 | 128 | 1 |
| Hayden, AL | $0.30 | $0.30 β $0.30 | 128 | 1 |
| Geneva, IL | $85.60 | $8.99 β $714.95 | 129 | 2 |
| Ocean, NJ | $1.18 | $1.18 β $1.18 | 129 | 1 |
| Waukee, IA | $0.00 | $0.00 β $0.00 | 129 | 2 |
| Lowville, NY | $0.44 | $0.44 β $0.44 | 129 | 1 |
| Rutledge, TN | $3.14 | $3.14 β $3.14 | 129 | 1 |
| Sealy, TX | $0.42 | $0.42 β $0.42 | 129 | 1 |
| Davis, OK | $2.85 | $2.85 β $2.85 | 129 | 1 |
| Carmi, IL | $0.76 | $0.00 β $1.49 | 129 | 3 |
| Peachtree Corners, GA | $635.92 | $635.92 β $635.92 | 129 | 1 |
| La Plata, MD | $18.20 | $18.20 β $18.20 | 130 | 1 |
| Vinton, LA | $0.90 | $0.90 β $0.90 | 130 | 1 |
| Blue Island, IL | $28.27 | $28.27 β $28.27 | 130 | 1 |
| Jonesboro, GA | $5.12 | $5.12 β $5.12 | 130 | 1 |
| Shelby, OH | $3.89 | $3.89 β $3.89 | 130 | 1 |
| Fountain Inn, SC | $6.55 | $6.55 β $6.55 | 131 | 1 |
| Iowa, LA | $0.17 | $0.17 β $0.17 | 131 | 1 |
| Winchester, IN | $0.00 | $0.00 β $0.00 | 132 | 1 |
| Lake Oswego, OR | $0.17 | $0.00 β $0.20 | 132 | 2 |
| Highland Village, TX | $4.09 | $4.09 β $4.09 | 132 | 1 |
| Belle Glade, FL | $1.69 | $1.69 β $1.69 | 132 | 1 |
| Bethel, VT | $60.51 | $60.51 β $60.51 | 132 | 1 |
| Nolensville, TN | $1.68 | $1.68 β $1.68 | 133 | 1 |
| Sisseton, SD | $2.90 | $0.70 β $3.14 | 133 | 2 |
| Anadarko, OK | $1.03 | $1.03 β $1.03 | 133 | 1 |
| Salmon, ID | $1.96 | $0.61 β $7.75 | 133 | 2 |
| Fort Gay, WV | $0.00 | $0.00 β $0.00 | 133 | 2 |
| Adairsville, GA | $0.51 | $0.32 β $1.11 | 133 | 2 |
| Enterprise, MS | $0.00 | $0.00 β $0.00 | 133 | 2 |
| Delta, CO | $214.91 | $0.00 β $958.03 | 134 | 4 |
| Prescott Valley, AZ | $6.02 | $1.00 β $11.17 | 134 | 3 |
| Pismo Beach, CA | $40.22 | $40.22 β $40.22 | 134 | 1 |
| Crawfordsville, IN | $0.00 | $0.00 β $0.00 | 134 | 2 |
| Marina, CA | $1.72 | $1.72 β $1.72 | 134 | 1 |
| Colfax, LA | $7.05 | $0.00 β $8.42 | 135 | 2 |
| Fremont, NE | $17.72 | $1.10 β $25.22 | 135 | 2 |
| Huntertown, IN | $3.18 | $3.18 β $3.18 | 135 | 1 |
| Gunnison, MS | $0.45 | $0.45 β $0.45 | 135 | 1 |
| Collinsville, OK | $0.16 | $0.16 β $0.16 | 136 | 1 |
| Coamo, PR | $0.00 | $0.00 β $0.00 | 136 | 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.