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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
Phelps, KY $11.86 $1.84 – $36.95 297 3
Medway, MA $3.29 $1.54 – $45.06 300 2
Prince George, VA $8.71 $0.17 – $14.41 300 4
Carthage, IL $1.00 $0.00 – $1.35 300 2
Pearl River, LA $0.73 $0.70 – $1.46 300 2
Mitchell, SD $15.44 $0.00 – $17.02 302 2
Buffalo Grove, IL $1.64 $1.64 – $1.64 302 1
Mc Cook, NE $0.14 $0.14 – $0.14 302 1
Lacey, WA $434.72 $0.51 – $511.54 303 3
Moon Twp, PA $0.00 $0.00 – $0.00 303 1
Kilmarnock, VA $0.30 $0.05 – $0.89 303 2
Littleton, CO $16.09 $0.00 – $77.87 304 6
Terrell, TX $70.43 $70.43 – $70.43 304 1
Brigham City, UT $0.02 $0.02 – $0.02 304 1
Plymouth, IN $0.54 $0.54 – $0.54 304 1
Rayne, LA $0.92 $0.00 – $4.42 304 5
Canton, MA $88.17 $12.17 – $337.59 304 2
Double Springs, AL $0.61 $0.61 – $0.61 304 1
Lawrenceburg, KY $1.21 $0.52 – $1.24 305 2
Goldendale, WA $12.42 $12.42 – $12.42 305 1
Oakhurst, NJ $0.15 $0.14 – $0.46 306 2
Robertsdale, AL $0.00 $0.00 – $0.00 306 1
Cut Bank, MT $0.00 $0.00 – $0.00 306 1
Seminole, OK $3.12 $0.00 – $12.00 307 5
Winfield, IL $280.79 $12.33 – $497.13 307 2
Haughton, LA $0.00 $0.00 – $0.00 307 1
Hamilton, AL $0.11 $0.00 – $0.45 308 4
Benton, AR $3.44 $0.00 – $18.46 309 5
La Vergne, TN $1.36 $1.10 – $1.83 310 2
Keokuk, IA $4.86 $0.00 – $33.42 311 3
Elsa, TX $0.87 $0.87 – $0.87 311 1
Little Hocking, OH $0.35 $0.35 – $0.35 311 1
Angleton, TX $26.13 $2.95 – $42.22 312 4
Carencro, LA $0.29 $0.01 – $0.96 313 6
Cadiz, OH $0.48 $0.09 – $0.51 313 2
Lobelville, TN $0.57 $0.57 – $0.57 313 1
Gorman, TX $1.05 $1.05 – $1.05 313 1
Crittenden, KY $13.55 $10.46 – $16.00 313 4
Forest, VA $0.53 $0.11 – $0.62 315 3
Spring, TX $0.31 $0.07 – $4.97 315 3
Webster, NY $182.13 $1.20 – $256.40 316 3
Post Falls, ID $1.46 $0.04 – $2.20 317 4
Deptford, NJ $0.13 $0.13 – $0.13 317 1
Englewood, OH $14.92 $0.00 – $97.27 319 7
Madison, CT $59.45 $59.45 – $59.45 322 1
Newberg, OR $337.47 $9.16 – $446.17 322 5
Cordova, AL $0.10 $0.10 – $0.10 322 1
Houlka, MS $0.29 $0.29 – $0.29 322 1
Early, TX $2.86 $2.86 – $2.86 323 1
Ayer, MA $101.03 $1.55 – $653.61 323 3

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.