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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
Calumet City, IL $730.34 $669.25 – $1,429 199 2
Barrow, AK $0.30 $0.00 – $0.61 199 2
Arcadia, LA $0.00 $0.00 – $0.00 199 2
Struthers, OH $0.13 $0.13 – $0.13 200 1
Fort Bragg, NC $6.74 $5.28 – $7.78 201 3
Ramer, TN $0.05 $0.05 – $0.05 201 1
Silvis, IL $57.11 $0.71 – $60.99 202 2
Bloomfield, IA $3.40 $0.00 – $15.95 202 2
New Castle, PA $0.01 $0.00 – $0.10 203 2
Smithfield, VA $8.84 $8.84 – $8.84 203 1
Gautier, MS $0.37 $0.37 – $0.37 204 1
Elkhart, KS $1.73 $1.73 – $1.73 204 1
Philippi, WV $33.41 $33.41 – $33.41 204 1
Pecos, TX $29.86 $0.00 – $34.23 204 2
Westerly, RI $0.00 $0.00 – $0.00 205 1
Bensalem, PA $45.95 $0.00 – $65.29 205 4
Huntsville, TX $21.49 $0.32 – $27.96 205 2
Kotzebue, AK $18.48 $18.48 – $18.48 205 1
Queens Village, NY $226.99 $226.99 – $226.99 206 1
Bonita Springs, FL $288.07 $10.18 – $308.34 206 2
Rancho Santa Margarita, CA $232.29 $1.12 – $553.84 206 3
Chubbuck, ID $0.08 $0.08 – $0.08 206 1
Aberdeen, SD $5.17 $0.05 – $7.56 207 2
Haddon Township, NJ $125.93 $125.93 – $125.93 207 1
Chipley, FL $0.00 $0.00 – $0.00 207 2
Leakesville, MS $1.16 $0.00 – $1.54 208 3
Albia, IA $0.00 $0.00 – $0.00 208 1
Farmersville, CA $0.98 $0.98 – $0.98 209 1
Bolivar, MO $0.63 $0.33 – $5.17 210 2
Abington, MA $0.07 $0.07 – $0.07 210 1
Logandale, NV $0.82 $0.82 – $0.82 211 1
Cutler, IN $0.00 $0.00 – $0.00 211 1
Rutland, VT $19.17 $0.00 – $61.58 212 4
Scarsdale, NY $52.49 $52.49 – $52.49 212 1
Roanoke, AL $0.62 $0.00 – $1.29 212 3
Wayland, KY $1.09 $1.09 – $1.09 212 1
Mt Juliet, TN $0.51 $0.31 – $0.88 213 4
Poplar, MT $0.00 $0.00 – $0.00 213 1
Cobleskill, NY $13.89 $13.89 – $13.89 214 1
Greenfield, TN $1.55 $1.10 – $2.42 214 2
Iselin, NJ $452.05 $452.05 – $452.05 215 1
Fairmount City, PA $0.88 $0.88 – $0.88 215 1
Bernice, LA $6.87 $0.00 – $82.44 216 3
Chilchinbeto, AZ $0.00 $0.00 – $0.00 216 1
Cankton, LA $0.00 $0.00 – $0.00 217 2
Sherborn, MA $0.24 $0.24 – $0.24 217 1
Plainview, TX $9.34 $0.28 – $78.40 218 6
Tavares, FL $0.82 $0.00 – $2.72 218 3
Clayton, NY $169.14 $169.14 – $169.14 218 1
Elizabeth, LA $0.00 $0.00 – $0.00 218 4

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.