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