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 |
|---|---|---|---|---|
| Temple City, CA | $44.26 | $44.26 β $44.26 | 7,337 | 1 |
| Bethlehem, PA | $1.19 | $0.00 β $11.17 | 7,345 | 8 |
| Newburgh, NY | $46.93 | $0.00 β $817.15 | 7,379 | 13 |
| Petaluma, CA | $18.32 | $9.93 β $68.50 | 7,379 | 3 |
| Longview, TX | $4.12 | $0.00 β $81.72 | 7,392 | 18 |
| Hudson, NY | $0.01 | $0.01 β $0.01 | 7,402 | 1 |
| Lebanon, VA | $0.24 | $0.16 β $1.07 | 7,420 | 4 |
| Dale City, VA | $0.39 | $0.39 β $0.39 | 7,438 | 1 |
| Cordova, TN | $18.75 | $0.00 β $46.45 | 7,445 | 15 |
| Beverly Hills, CA | $24.70 | $0.00 β $550.51 | 7,455 | 12 |
| Panama City Beach, FL | $0.33 | $0.31 β $3.15 | 7,463 | 2 |
| Sevierville, TN | $20.56 | $0.23 β $82.40 | 7,464 | 29 |
| Santa Isabel, PR | $1.65 | $1.65 β $1.65 | 7,471 | 1 |
| Denville, NJ | $3.86 | $3.86 β $3.86 | 7,481 | 1 |
| West Valley City, UT | $0.98 | $0.00 β $0.98 | 7,484 | 3 |
| South Plainfield, NJ | $31.04 | $8.64 β $31.27 | 7,492 | 3 |
| Cortland, NY | $0.58 | $0.06 β $84.00 | 7,495 | 5 |
| Oak Ridge, TN | $1.17 | $0.18 β $63.69 | 7,506 | 23 |
| Manchester, TN | $1.59 | $0.03 β $4.65 | 7,513 | 15 |
| Durango, CO | $220.62 | $0.00 β $706.52 | 7,526 | 20 |
| Panama City, FL | $11.95 | $0.00 β $39.87 | 7,528 | 32 |
| Odessa, TX | $12.84 | $0.00 β $65.28 | 7,532 | 23 |
| Fabens, TX | $1.04 | $1.04 β $1.04 | 7,537 | 1 |
| Allen Park, MI | $0.99 | $0.08 β $15.28 | 7,546 | 7 |
| Sandy, UT | $7.95 | $0.00 β $9.82 | 7,584 | 3 |
| Mount Laurel, NJ | $35.30 | $1.17 β $69.96 | 7,591 | 4 |
| Sylacauga, AL | $7.68 | $0.20 β $63.69 | 7,606 | 13 |
| Tehachapi, CA | $3.29 | $3.29 β $3.29 | 7,626 | 1 |
| District Heights, MD | $2.10 | $0.00 β $26.74 | 7,626 | 3 |
| Centreville, AL | $0.42 | $0.00 β $6.71 | 7,655 | 9 |
| Thornton, CO | $22.20 | $0.00 β $265.97 | 7,664 | 25 |
| North Windham, CT | $3.98 | $3.98 β $3.98 | 7,703 | 1 |
| North Chelmsford, MA | $4.10 | $2.02 β $8.00 | 7,713 | 9 |
| Randallstown, MD | $0.39 | $0.00 β $0.44 | 7,726 | 4 |
| Wilmington, OH | $5.44 | $0.00 β $86.51 | 7,735 | 7 |
| Greeley, CO | $24.64 | $0.00 β $337.55 | 7,736 | 23 |
| Cerritos, CA | $7.20 | $0.00 β $9.83 | 7,748 | 8 |
| La Palma, CA | $22.79 | $0.43 β $26.29 | 7,753 | 3 |
| Gloversville, NY | $0.14 | $0.11 β $2.76 | 7,815 | 2 |
| Rogersville, TN | $0.66 | $0.21 β $8.79 | 7,817 | 9 |
| Avon, OH | $0.08 | $0.00 β $2.09 | 7,820 | 7 |
| Franklin, WI | $23.04 | $0.00 β $517.88 | 7,825 | 4 |
| Payson, AZ | $2.17 | $0.01 β $2.34 | 7,843 | 3 |
| Jonesboro, LA | $1.65 | $0.00 β $2.17 | 7,882 | 7 |
| Zeeland, MI | $0.00 | $0.00 β $0.00 | 7,885 | 1 |
| North Hollywood, CA | $23.18 | $0.00 β $23.65 | 7,954 | 5 |
| Brooklawn, NJ | $8.39 | $8.39 β $8.39 | 7,960 | 1 |
| Easton, MD | $14.88 | $0.00 β $546.99 | 7,978 | 17 |
| Huber Heights, OH | $1.00 | $0.00 β $10.92 | 7,983 | 6 |
| Oak Park, IL | $10.00 | $0.00 β $43.55 | 8,026 | 5 |
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.