Skip to content
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
Pollock, LA $0.00 $0.00 – $0.00 368 1
Whiting, NJ $5.56 $5.56 – $5.56 369 1
Warsaw, KY $9.94 $6.07 – $12.47 369 2
Quincy, CA $20.11 $4.49 – $24.43 369 2
Palm Coast, FL $9.52 $0.13 – $272.33 370 3
Narberth, PA $0.92 $0.92 – $0.92 370 1
Bolingbrook, IL $1.31 $1.09 – $6.39 371 2
Desoto, TX $0.22 $0.00 – $0.36 372 3
Northville, MI $55.91 $55.91 – $55.91 372 1
Madill, OK $20.59 $20.59 – $20.59 372 1
North Franklin, CT $0.54 $0.54 – $0.54 374 1
Clementon, NJ $0.03 $0.03 – $0.03 374 1
Sycamore, IL $26.60 $1.66 – $66.93 375 4
Bluffton, IN $0.11 $0.00 – $1.40 376 5
Fishkill, NY $1.64 $1.64 – $1.64 377 1
Manhattan, KS $55.07 $0.00 – $422.45 378 4
Zion, IL $1.11 $1.11 – $1.11 378 1
Grand Coulee, WA $10.80 $10.80 – $10.80 379 1
Marion, SC $56.60 $56.60 – $56.60 379 1
Newellton, LA $0.00 $0.00 – $0.00 379 1
Erin, TN $5.19 $0.51 – $6.02 379 2
St Paul, KS $0.84 $0.84 – $0.84 380 1
Princeton, IN $1.50 $0.00 – $2.35 381 4
Dacula, GA $0.86 $0.86 – $0.86 382 1
Columbus, NE $8.30 $5.40 – $12.76 383 2
Woodstock, GA $0.18 $0.17 – $0.23 384 2
Lyndhurst, OH $323.28 $0.00 – $441.35 385 2
Mooresville, NC $9.82 $0.32 – $14.23 387 3
Mineral Ridge, OH $0.40 $0.40 – $0.43 387 2
Ventnor City, NJ $21.19 $21.19 – $21.19 387 1
Glendive, MT $1.63 $1.63 – $1.63 388 1
San Benito, TX $2.45 $1.69 – $2.49 388 2
Uvalde, TX $3.18 $2.56 – $5.30 389 2
Lewisburg, TN $0.84 $0.56 – $1.44 389 4
Munford, TN $3.81 $1.38 – $6.73 389 2
Nanuet, NY $208.19 $1.25 – $1,080 391 2
Amery, WI $0.00 $0.00 – $0.00 391 2
Southington, CT $0.58 $0.19 – $1.56 391 2
Hereford, AZ $0.72 $0.72 – $0.72 391 1
Franklin, MI $6.36 $6.36 – $6.36 391 1
Gresham, OR $0.84 $0.00 – $18.58 392 9
Harahan, LA $0.29 $0.18 – $0.34 392 2
Woonsocket, RI $60.85 $3.76 – $84.00 392 7
N Chelmsford, MA $3.71 $2.88 – $7.79 392 2
Eastchester, NY $285.84 $6.60 – $375.44 393 3
Dixon Springs, TN $3.83 $3.83 – $3.83 393 1
Sneedville, TN $0.56 $0.39 – $1.75 394 3
Haledon, NJ $1.84 $1.84 – $1.84 394 1
Pine Prairie, LA $0.23 $0.00 – $0.73 394 2
Maynardville, TN $1.29 $0.48 – $1.37 395 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.