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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
Medina, NY $0.08 $0.08 – $0.08 14 1
Lawndale, CA $0.00 $0.00 – $0.00 14 1
Olivia, MN $1.00 $1.00 – $1.00 14 1
Tecumseh, MI $0.00 $0.00 – $0.00 14 1
Apple Valley, MN $0.00 $0.00 – $0.00 14 1
Willow Springs, MO $0.07 $0.07 – $0.07 14 1
Garfield Hts, OH $1.36 $1.36 – $1.36 14 1
Myrtle, MS $0.45 $0.45 – $0.45 14 1
Fords, NJ $0.47 $0.47 – $0.47 14 1
Woodburn, OR $0.96 $0.96 – $0.96 14 1
Murrysville, PA $0.11 $0.11 – $0.11 14 1
Winner, SD $0.00 $0.00 – $0.00 14 1
Lemon Grove, CA $0.00 $0.00 – $0.00 14 1
Demotte, IN $0.00 $0.00 – $0.00 14 1
Dawsonville, GA $1.15 $1.15 – $1.15 14 1
Bar Harbor, ME $2.57 $2.57 – $2.57 14 1
Mayer, AZ $0.09 $0.09 – $0.09 14 1
Corcoran, CA $0.00 $0.00 – $0.00 14 1
Louisa, VA $5.23 $5.23 – $5.23 14 1
Floyd, VA $2.07 $2.07 – $2.07 14 1
Refugio, TX $0.44 $0.44 – $0.44 14 1
Eureka, MT $0.43 $0.43 – $0.43 14 1
Los Ranchos, NM $5.34 $5.34 – $5.34 14 1
Commerce Twp, MI $6.67 $6.67 – $6.67 14 1
Smiths Grove, KY $0.88 $0.88 – $0.88 14 1
Benton City, WA $0.58 $0.58 – $0.58 14 1
Carolina Shores, NC $0.47 $0.47 – $0.47 14 1
Seabrook, TX $30.68 $30.68 – $30.68 14 1
College Grove, TN $0.82 $0.82 – $0.82 14 1
Canada, KY $0.08 $0.08 – $0.08 14 1
Ty Ty, GA $0.85 $0.85 – $0.85 14 1
Eden Prairie, MN $1,237 $1,237 – $1,237 13 1
Tallmadge, OH $1.21 $1.21 – $1.21 13 1
Alexandria, KY $12.87 $12.87 – $12.87 13 1
Grand Jct, CO $0.00 $0.00 – $0.00 13 1
Du Quoin, IL $0.00 $0.00 – $0.00 13 1
San Clemente, CA $43.77 $43.77 – $43.77 13 1
Fuquay Varina, NC $79.70 $79.70 – $79.70 13 1
Caneyville, KY $9.94 $9.94 – $9.94 13 1
Beltsville, MD $0.00 $0.00 – $0.00 13 1
Coralville, IA $0.00 $0.00 – $0.00 13 1
Crystal River, FL $0.00 $0.00 – $0.00 13 1
Kitty Hawk, NC $33.35 $33.35 – $33.35 13 1
Manalapan, NJ $0.39 $0.39 – $0.39 13 1
Robstown, TX $4.11 $4.11 – $4.11 13 1
Nathalie, VA $16.20 $16.20 – $16.20 13 1
Bellaire, OH $6.83 $6.83 – $6.83 13 1
Darby, PA $0.00 $0.00 – $0.00 13 1
Brentwood, NY $1.04 $1.04 – $1.04 13 1
Follansbee, WV $11.40 $11.40 – $11.40 13 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.