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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
Taylorsville, KY $1.00 $1.00 – $1.00 13 1
Oberlin, KS $0.00 $0.00 – $0.00 13 1
Dedham, MA $2.11 $2.11 – $2.11 13 1
Red Springs, NC $0.99 $0.99 – $0.99 13 1
Mc Leansboro, IL $0.00 $0.00 – $0.00 13 1
Milford, MI $1.05 $1.05 – $1.05 13 1
Altadena, CA $5.46 $5.46 – $5.46 13 1
Purcell, OK $0.00 $0.00 – $0.00 13 1
Fraser, MI $0.50 $0.50 – $0.50 13 1
North Olmsted, OH $95.66 $95.66 – $95.66 13 1
Fort Belvoir, VA $0.00 $0.00 – $0.00 13 1
Toccoa, GA $0.73 $0.73 – $0.73 13 1
Setauket, NY $5.88 $5.88 – $5.88 13 1
Nantucket, MA $0.00 $0.00 – $0.00 13 1
Whitesboro, NY $0.47 $0.47 – $0.47 13 1
Alma, AR $7.07 $7.07 – $7.07 13 1
Holyoke, CO $1.59 $1.59 – $1.59 13 1
Monte Vista, CO $0.00 $0.00 – $0.00 13 1
West Babylon, NY $9.40 $9.40 – $9.40 13 1
Connersville, IN $0.00 $0.00 – $0.00 13 1
Shelby Twp, MI $0.88 $0.88 – $0.88 13 1
Gravette, AR $0.00 $0.00 – $0.00 13 1
Moriarty, NM $0.75 $0.75 – $0.75 13 1
Falcon, CO $0.00 $0.00 – $0.00 13 1
Freeville, NY $0.08 $0.08 – $0.08 13 1
Carrington, ND $3.66 $3.66 – $3.66 13 1
Amherst, VA $0.30 $0.30 – $0.30 13 1
Morrison, IL $1.27 $1.27 – $1.27 13 1
Belcourt, ND $40.27 $40.27 – $40.27 13 1
Negaunee, MI $37.38 $37.38 – $37.38 13 1
Houston, MO $1.79 $1.79 – $1.79 13 1
Wheeler, OR $56.32 $56.32 – $56.32 13 1
Forestville, MD $0.85 $0.85 – $0.85 13 1
Cottage Grove, WI $1.03 $1.03 – $1.03 13 1
Richmond Hts, OH $0.00 $0.00 – $0.00 13 1
Guadalupe, AZ $0.00 $0.00 – $0.00 13 1
Jefferson, OH $1.00 $1.00 – $1.00 13 1
John Day, OR $9.01 $9.01 – $9.01 13 1
Rugby, ND $0.86 $0.86 – $0.86 13 1
Belleville, MI $1.21 $1.21 – $1.21 13 1
Maurepas, LA $0.00 $0.00 – $0.00 13 1
Bangor, MI $57.46 $57.46 – $57.46 13 1
Jones, OK $1.22 $1.22 – $1.22 13 1
Decaturville, TN $1.27 $1.27 – $1.27 13 1
Springfield, LA $0.00 $0.00 – $0.00 13 1
Whitehouse, OH $0.00 $0.00 – $0.00 13 1
Strawberry, AR $0.12 $0.12 – $0.12 13 1
East Point, KY $1.22 $1.22 – $1.22 13 1
Tougaloo, MS $0.64 $0.64 – $0.64 13 1
Morgantown, WA $67.29 $67.29 – $67.29 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.