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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
National City, CA $3.66 $2.41 – $101.79 28,242 3
Waukesha, WI $5.05 $2.82 – $389.68 28,233 3
Kansas City, MO $0.53 $0.00 – $430.64 28,205 30
Murfreesboro, TN $9.88 $0.00 – $930.04 28,013 54
Fond Du Lac, WI $1.05 $0.01 – $85.50 27,985 9
Savannah, TN $1.73 $0.00 – $10.37 27,931 25
Morehead, KY $14.33 $0.28 – $47.41 27,907 22
Henderson, KY $7.39 $0.16 – $74.59 27,904 16
Michigan City, IN $1.08 $0.00 – $49.75 27,825 10
Flowood, MS $0.39 $0.00 – $8.02 27,761 18
Flagstaff, AZ $10.00 $0.00 – $1,095 27,738 26
Putnam, CT $0.05 $0.01 – $1.71 27,722 5
Coushatta, LA $0.57 $0.00 – $39.24 27,669 15
Nassawadox, VA $0.13 $0.13 – $0.13 27,630 1
Corpus Christi, TX $10.69 $0.00 – $121.90 27,609 85
Sun City West, AZ $1.74 $0.00 – $151.17 27,504 8
Greer, SC $0.20 $0.00 – $6.59 27,287 6
Starkville, MS $1.63 $0.00 – $63.06 27,126 17
Long Branch, NJ $4.13 $0.94 – $54.19 27,014 3
Fremont, CA $29.12 $0.00 – $1,072 27,009 14
Kingsport, TN $25.05 $0.00 – $1,029 27,003 49
Northridge, CA $40.23 $1.50 – $765.23 26,992 10
Burbank, CA $6.98 $0.00 – $14.62 26,971 13
Somers Point, NJ $9.05 $1.96 – $706.14 26,971 7
Shiprock, NM $3.12 $3.12 – $3.12 26,755 1
Burien, WA $1.12 $0.29 – $1,202 26,730 4
Helena, MT $11.72 $0.00 – $1,052 26,679 10
Garden City, MI $1.66 $0.00 – $17.74 26,640 9
Oak Creek, WI $0.07 $0.00 – $6.07 26,594 4
Des Moines, IA $101.32 $0.00 – $1,428 26,526 82
Natchez, MS $0.56 $0.00 – $2.70 26,469 18
Ellsworth, ME $0.01 $0.00 – $0.03 26,437 2
Leesville, LA $0.51 $0.00 – $27.93 26,423 22
Calabash, NC $0.99 $0.99 – $0.99 26,400 1
Wisconsin Rapids, WI $0.76 $0.00 – $16.85 26,342 3
Bozeman, MT $3.62 $0.54 – $601.06 26,255 8
Gary, IN $1.44 $0.00 – $34.72 26,227 13
Taylor, MI $77.57 $0.00 – $797.05 26,106 12
Pensacola, FL $9.31 $0.00 – $337.33 25,805 43
Lawrenceburg, TN $8.69 $0.01 – $347.51 25,746 41
Martin, TN $0.78 $0.00 – $5.78 25,725 13
Prestonsburg, KY $9.30 $0.00 – $74.94 25,592 29
Williamsburg, VA $9.50 $0.06 – $851.79 25,542 13
Blairs, VA $0.02 $0.02 – $0.02 25,536 1
Santa Fe, NM $36.04 $0.01 – $784.43 25,518 22
Oroville, CA $10.09 $0.00 – $13.06 25,502 8
Wayne, MI $3.04 $0.00 – $739.33 25,500 2
Moses Lake, WA $2.65 $0.07 – $92.98 25,403 15
Port Gibson, MS $3.54 $0.00 – $3.94 25,378 11
Parma Heights, OH $1.04 $0.00 – $1.30 25,337 4

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.