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 |
|---|---|---|---|---|
| Fridley, MN | $1.20 | $0.02 β $12.58 | 276 | 6 |
| Fort Pierce, FL | $17.12 | $0.08 β $33.54 | 276 | 6 |
| Ewing, NJ | $7.00 | $7.00 β $7.00 | 278 | 1 |
| New Philadelphia, OH | $72.10 | $72.10 β $72.10 | 278 | 1 |
| Hoquiam, WA | $32.09 | $32.09 β $32.09 | 278 | 1 |
| Blanchard, OK | $1.04 | $0.86 β $1.12 | 278 | 2 |
| Halfmoon, NY | $30.27 | $7.72 β $39.41 | 279 | 3 |
| Louisville, CO | $0.99 | $0.00 β $1.60 | 279 | 5 |
| Westminster, MD | $0.89 | $0.00 β $1.49 | 280 | 4 |
| Forestdale, AL | $1.05 | $1.05 β $1.05 | 280 | 1 |
| Hereford, TX | $47.67 | $3.68 β $56.50 | 281 | 2 |
| Fort Hood, TX | $1.11 | $0.00 β $5.58 | 281 | 5 |
| Moundsvillle, WV | $0.26 | $0.26 β $0.26 | 281 | 1 |
| Belden, MS | $0.77 | $0.31 β $1.05 | 282 | 2 |
| Long Beach, NY | $0.63 | $0.39 β $3.30 | 283 | 3 |
| Valley Cottage, NY | $140.36 | $140.36 β $140.36 | 283 | 1 |
| Trussville, AL | $0.80 | $0.54 β $1.14 | 283 | 4 |
| Collins, MS | $15.69 | $0.00 β $50.03 | 284 | 3 |
| East Weymouth, MA | $1,223 | $1,177 β $1,426 | 285 | 2 |
| Newport, AR | $10.42 | $0.00 β $22.85 | 286 | 4 |
| Macomb, IL | $10.98 | $0.00 β $38.33 | 286 | 4 |
| Dennison, OH | $0.06 | $0.06 β $0.07 | 286 | 2 |
| Kimball, MI | $8.62 | $8.62 β $8.62 | 286 | 1 |
| Dixon, IL | $50.35 | $1.33 β $56.07 | 287 | 2 |
| Little River, SC | $4.40 | $0.46 β $73.17 | 287 | 3 |
| Canaan, IN | $62.15 | $62.15 β $62.15 | 287 | 1 |
| Nags Head, NC | $5.90 | $1.82 β $9.78 | 288 | 5 |
| Altoona, PA | $0.02 | $0.00 β $0.41 | 288 | 5 |
| Cortland, OH | $0.82 | $0.00 β $2.06 | 288 | 3 |
| Jonesville, LA | $1.25 | $0.53 β $1.98 | 288 | 2 |
| Lincoln Park, NJ | $295.62 | $295.62 β $295.62 | 289 | 1 |
| Fort Campbell, KY | $1.23 | $0.02 β $6.09 | 290 | 4 |
| Duluth, GA | $4.35 | $0.01 β $6.66 | 291 | 4 |
| Buckeye, WV | $19.15 | $1.34 β $35.67 | 291 | 2 |
| Dallas, PA | $0.00 | $0.00 β $0.00 | 291 | 1 |
| Phillips, WI | $3.79 | $3.79 β $3.79 | 291 | 1 |
| Sheridan, WY | $18.94 | $0.87 β $32.31 | 292 | 4 |
| Walnut Grove, MS | $0.00 | $0.00 β $0.00 | 292 | 2 |
| Clinton, AR | $0.58 | $0.41 β $0.93 | 293 | 2 |
| Shenandoah, IA | $2.29 | $2.29 β $2.29 | 293 | 1 |
| Randolph, MA | $0.84 | $0.84 β $0.84 | 293 | 1 |
| Pataskala, OH | $55.52 | $45.05 β $85.30 | 293 | 3 |
| Guymon, OK | $0.53 | $0.17 β $1.00 | 293 | 3 |
| East Palatka, FL | $9.87 | $9.87 β $9.87 | 293 | 1 |
| Soledad, CA | $3.24 | $3.24 β $3.24 | 293 | 1 |
| Lenox, MI | $10.03 | $10.03 β $10.03 | 293 | 1 |
| Clarksville, AR | $5.58 | $3.01 β $13.94 | 294 | 2 |
| Warner Robins, GA | $0.40 | $0.01 β $1.84 | 295 | 5 |
| Live Oak, TX | $3.35 | $0.84 β $26.78 | 296 | 5 |
| Sylacouga, AL | $0.32 | $0.32 β $0.32 | 297 | 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.