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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
Cranberry Twp, PA $0.00 $0.00 – $0.00 19 1
Branchburg, NJ $0.00 $0.00 – $0.00 19 1
Brookville, OH $0.38 $0.38 – $0.38 19 1
Dade City, FL $0.00 $0.00 – $0.00 19 1
Rutherford College, NC $1.57 $1.57 – $1.57 19 1
Fort Washington, PA $0.00 $0.00 – $0.00 19 1
Section, AL $0.00 $0.00 – $0.00 19 1
Chowchilla, CA $0.00 $0.00 – $0.00 19 1
Friona, TX $18.67 $18.67 – $18.67 19 1
West Lake Hills, TX $0.18 $0.18 – $0.18 19 1
Reedsport, OR $5.29 $5.29 – $5.29 19 1
Cullowhee, NC $0.00 $0.00 – $0.00 19 1
Citrus Springs, FL $0.00 $0.00 – $0.00 19 1
La Vernia, TX $0.00 $0.00 – $0.00 19 1
Hardy, VA $676.21 $676.21 – $676.21 20 1
Cresco, IA $39.17 $39.17 – $39.17 20 1
Saint Charles, MO $0.00 $0.00 – $0.00 20 1
Elk Grove Village, IL $1.20 $1.20 – $1.20 20 1
Atlantic City, NJ $8.11 $8.11 – $8.11 20 1
Helotes, TX $1.27 $1.27 – $1.27 20 1
Leesville, SC $2.39 $2.39 – $2.39 20 1
Glencoe, MN $29.81 $29.81 – $29.81 20 1
Weyers Cave, VA $0.36 $0.36 – $0.36 20 1
Swanton, OH $0.00 $0.00 – $0.00 20 1
Saratoga Springs, UT $5.19 $5.19 – $5.19 20 1
Bradley, IL $8.35 $8.35 – $8.35 20 1
Hidden Valley Lake, CA $0.67 $0.67 – $0.67 20 1
Rossville, TN $0.01 $0.01 – $0.01 20 1
Kennebunk, ME $0.53 $0.53 – $0.53 21 1
Cayey, PR $0.01 $0.01 – $0.01 21 1
Augusta, KY $4.96 $4.96 – $4.96 21 1
Sibley, LA $0.80 $0.80 – $0.80 21 1
Caldwell, WV $7.61 $7.61 – $7.61 21 1
Hanceville, AL $2.56 $2.56 – $2.56 22 1
Ponchatoula, LA $0.47 $0.47 – $0.47 22 1
Brookings, OR $10.93 $10.93 – $10.93 22 1
Clarion, PA $0.69 $0.69 – $0.69 22 1
Pewaukee, WI $0.00 $0.00 – $0.00 22 1
Lackey, KY $27.95 $27.95 – $27.95 22 1
Solvang, CA $0.10 $0.10 – $0.10 22 1
Sugarhill, GA $1.96 $1.96 – $1.96 22 1
Ely, NV $0.00 $0.00 – $0.00 22 1
Kathleen, GA $0.08 $0.08 – $0.08 22 1
Ocoee, TN $0.06 $0.06 – $0.06 22 1
Forest Hill, WV $0.00 $0.00 – $0.00 22 1
East Saint Louis, IL $0.00 $0.00 – $0.00 23 1
Matthews, MO $0.00 $0.00 – $0.00 23 1
Mcconnell Afb, KS $1.60 $1.60 – $1.60 23 1
Richmond, MI $0.26 $0.26 – $0.26 23 1
Plymouth, MN $7.40 $7.40 – $7.40 24 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.