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