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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
Grimes, IA $28.40 $28.40 – $28.40 323 1
Jenkins, KY $12.79 $7.23 – $14.39 323 2
Port Sulphur, LA $0.18 $0.18 – $0.18 323 1
La Porte, TX $0.88 $0.88 – $0.88 324 1
Glen Morgan, WV $1.50 $1.50 – $1.50 324 1
Moscow, OH $0.10 $0.10 – $0.10 324 1
Norfolk, NE $5.44 $0.00 – $5.66 325 2
St Clair Shores, MI $325.33 $2.22 – $947.80 325 4
Brighton, TN $1.67 $1.67 – $1.67 325 1
South Pittsburg, TN $0.56 $0.33 – $1.01 325 3
Mullens, WV $0.54 $0.00 – $2.08 325 2
Dequincy, LA $8.71 $0.57 – $53.76 326 4
Greendale, IN $0.76 $0.76 – $0.76 326 1
Newcastle, OK $0.08 $0.00 – $0.94 328 2
Moraine, OH $67.64 $40.56 – $87.31 328 2
Summit, MS $0.83 $0.83 – $0.83 328 1
Morton, WA $28.94 $28.94 – $28.94 329 1
Peterborough, NH $4.68 $4.68 – $4.68 330 1
Tahlequah, OK $1.90 $0.00 – $6.37 331 9
Los Gatos, CA $8.76 $3.47 – $29.82 331 4
Harker Heights, TX $1.12 $0.00 – $1.92 331 6
New Martinsville, WV $26.60 $0.84 – $93.42 331 4
Advance, NC $11.66 $11.66 – $11.66 331 1
Brookhaven, PA $2.94 $2.94 – $2.94 332 1
Highland Heights, KY $9.72 $0.00 – $14.16 334 4
Canoga Park, CA $2.44 $0.00 – $8.06 334 2
Corsicana, TX $131.22 $131.22 – $131.22 334 1
Bryan, TX $8.70 $0.00 – $99.47 335 3
Cypress, TX $4.13 $0.45 – $7.36 335 3
Ramer, AL $0.68 $0.68 – $0.68 335 1
Winton, CA $11.55 $11.55 – $11.55 335 1
Palmview, TX $0.43 $0.43 – $0.43 336 1
Munford, AL $1.40 $1.40 – $1.40 337 1
Mineral Wells, TX $28.75 $0.00 – $48.24 338 6
Stoneham, MA $4.51 $1.76 – $22.01 338 5
Absecon, NJ $168.18 $168.18 – $168.18 339 1
Sebastopol, MS $0.52 $0.52 – $0.52 339 1
Hickman, KY $8.86 $0.62 – $40.52 339 2
Miles City, MT $0.42 $0.42 – $0.42 340 1
Vero Beach, FL $23.28 $0.00 – $370.43 341 6
Rock Island, IL $9.96 $4.13 – $10.31 341 2
St. Francisville, LA $0.30 $0.30 – $0.30 341 1
Baldwin, WI $0.00 $0.00 – $0.00 341 1
Maitland, FL $6.66 $0.00 – $42.17 342 6
Mount Vernon, AL $0.00 $0.00 – $0.00 342 1
Wrightsville, GA $0.00 $0.00 – $0.00 342 1
Tamuning, GU $29.95 $0.95 – $85.50 344 5
Cottage City, MD $10.87 $10.87 – $10.87 344 1
Mount Prospect, IL $30.44 $30.44 – $30.44 345 1
Wharton, TX $71.57 $70.85 – $72.50 346 2

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.