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 |
|---|---|---|---|---|
| Great Barrington, MA | $2.48 | $2.48 β $2.48 | 167 | 1 |
| Bridgeton, MO | $0.00 | $0.00 β $0.00 | 168 | 2 |
| Vestavia, AL | $0.68 | $0.34 β $0.74 | 168 | 2 |
| Poulsbo, WA | $76.95 | $76.95 β $76.95 | 168 | 1 |
| Andrews, TX | $2.94 | $1.78 β $5.25 | 168 | 2 |
| Capac, MI | $1.14 | $1.14 β $1.14 | 168 | 1 |
| Wakefield, RI | $0.65 | $0.57 β $0.79 | 169 | 3 |
| Pearisburg, VA | $0.92 | $0.92 β $0.92 | 169 | 1 |
| Benton, TN | $1.71 | $0.48 β $2.20 | 169 | 2 |
| Greencastle, IN | $8.06 | $8.06 β $8.06 | 171 | 1 |
| Greenville, IL | $38.34 | $0.00 β $42.03 | 171 | 2 |
| Bear, DE | $0.17 | $0.17 β $0.17 | 171 | 1 |
| Mammoth Spring, AR | $0.12 | $0.12 β $0.12 | 171 | 1 |
| Hazlehurst, GA | $1.56 | $1.56 β $1.56 | 172 | 1 |
| Big Bear Lake, CA | $2.22 | $2.22 β $2.22 | 172 | 1 |
| Blue Mountain, MS | $0.00 | $0.00 β $0.00 | 172 | 1 |
| Penitas, TX | $0.17 | $0.17 β $0.17 | 172 | 1 |
| Belle Chasse, LA | $0.52 | $0.51 β $0.52 | 173 | 2 |
| Covington, GA | $0.84 | $0.78 β $0.89 | 173 | 2 |
| Rives, TN | $0.00 | $0.00 β $0.00 | 173 | 1 |
| Tremonton, UT | $2.69 | $2.69 β $2.69 | 174 | 1 |
| Liberal, KS | $3.18 | $3.00 β $3.60 | 175 | 2 |
| Kendallville, IN | $44.07 | $44.07 β $44.07 | 175 | 1 |
| Dumfries, VA | $0.00 | $0.00 β $0.00 | 175 | 1 |
| Snoqualmie, WA | $18.14 | $2.07 β $21.87 | 175 | 2 |
| Lady Lake, FL | $14.27 | $14.27 β $14.27 | 176 | 1 |
| Fogelsville, PA | $1,158 | $1,158 β $1,158 | 176 | 1 |
| Sumrall, MS | $0.52 | $0.00 β $0.62 | 176 | 3 |
| Potts Camp, MS | $3.98 | $3.98 β $3.98 | 176 | 1 |
| Spring Branch, TX | $2.08 | $2.08 β $2.08 | 176 | 1 |
| Coleman, TX | $0.40 | $0.40 β $0.40 | 177 | 1 |
| Douglas, GA | $6.95 | $6.95 β $6.95 | 177 | 1 |
| Boyce, LA | $0.71 | $0.71 β $0.71 | 177 | 1 |
| Harrisonburg, LA | $8.40 | $8.40 β $8.40 | 177 | 1 |
| Reisterstown, MD | $0.00 | $0.00 β $0.00 | 178 | 1 |
| Greensburg, IN | $7.58 | $0.00 β $88.07 | 178 | 3 |
| Avon Park, FL | $570.07 | $0.11 β $622.52 | 178 | 2 |
| La Jara, CO | $0.70 | $0.00 β $4.99 | 178 | 4 |
| Lorton, VA | $0.19 | $0.18 β $0.32 | 178 | 2 |
| Red Wing, MN | $0.01 | $0.01 β $0.01 | 179 | 1 |
| Scottdale, PA | $0.00 | $0.00 β $0.00 | 179 | 1 |
| Madisonville, TN | $0.32 | $0.15 β $0.79 | 179 | 5 |
| Orange, TX | $25.93 | $8.75 β $31.18 | 180 | 3 |
| Slippery Rock, PA | $0.00 | $0.00 β $0.00 | 180 | 1 |
| Gray, TN | $0.25 | $0.15 β $0.52 | 182 | 2 |
| North Vernon, IN | $0.57 | $0.16 β $0.64 | 182 | 2 |
| Bermuda Run, NC | $2.25 | $2.25 β $2.25 | 182 | 1 |
| Harrisburg, NC | $29.02 | $26.48 β $59.55 | 182 | 2 |
| Jerome, ID | $1.23 | $1.23 β $1.23 | 182 | 1 |
| Roxboro, NC | $0.00 | $0.00 β $0.00 | 183 | 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.