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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
Valhalla, NY $1.09 $0.21 – $646.85 18,314 3
Elmhurst, NY $36.79 $0.09 – $538.78 18,292 10
Seneca, SC $0.46 $0.00 – $18.65 18,163 13
Lake Providence, LA $0.00 $0.00 – $0.01 18,120 10
Dillon, SC $1.53 $0.10 – $80.08 18,116 13
Reedley, CA $5.39 $0.00 – $10.14 18,077 9
Covington, WA $0.13 $0.13 – $0.36 18,042 2
Jamestown, TN $2.63 $0.00 – $7.38 17,972 14
Biloxi, MS $0.66 $0.00 – $32.81 17,916 15
Covington, LA $28.19 $0.00 – $170.50 17,820 40
Petoskey, MI $0.11 $0.02 – $5.57 17,779 2
Salyersville, KY $4.59 $0.17 – $22.00 17,755 12
Opelousas, LA $5.95 $0.00 – $19.41 17,714 37
Willimantic, CT $0.06 $0.00 – $56.38 17,654 3
Buena Park, CA $6.22 $0.79 – $6.81 17,644 7
Greensboro, GA $0.29 $0.07 – $6.08 17,600 3
Lorain, OH $1.76 $0.00 – $168.39 17,584 23
Cherry Hill, NJ $37.82 $0.00 – $430.99 17,580 9
Hartsville, SC $2.10 $0.10 – $87.79 17,533 15
Concord, CA $7.34 $0.00 – $54.98 17,531 10
Carthage, MS $0.92 $0.00 – $4.87 17,449 15
Napa, CA $73.42 $2.91 – $1,059 17,433 5
Beckley, WV $33.19 $0.00 – $145.84 17,425 23
Spring Hill, TN $0.64 $0.29 – $2.20 17,370 5
Safford, AZ $0.15 $0.03 – $7.79 17,349 3
Yazoo City, MS $0.61 $0.00 – $0.84 17,330 7
Aberdeen, WA $0.79 $0.04 – $20.96 17,323 6
Terre Haute, IN $43.73 $0.00 – $340.03 17,305 39
Hillsdale, MI $1.84 $0.70 – $11.58 17,225 4
South Gate, CA $40.26 $0.02 – $139.08 17,220 9
Waterford, MI $9.34 $0.00 – $9.75 17,194 7
Ocala, FL $5.15 $0.00 – $280.42 17,182 26
Queen Creek, AZ $1.06 $0.00 – $81.60 17,167 3
Grafton, WI $0.18 $0.03 – $17.12 17,144 3
Greenbelt, MD $336.79 $-0.01 – $1,743 17,009 17
San Marcos, CA $148.23 $0.00 – $1,584 16,998 12
West Bloomfield, MI $9.09 $0.03 – $875.21 16,940 4
Logan, UT $9.41 $0.87 – $921.61 16,931 5
Oak Grove, LA $0.96 $0.00 – $16.10 16,871 8
Lake Havasu City, AZ $2.21 $1.35 – $79.80 16,863 4
Seatac, WA $18.16 $16.61 – $18.92 16,815 3
Plattsburgh, NY $144.62 $0.00 – $815.21 16,797 7
Fairview, NJ $3.45 $3.45 – $3.45 16,761 1
Bridgeton, NJ $12.87 $12.76 – $18.34 16,755 2
Harlingen, TX $5.93 $0.00 – $71.25 16,734 28
Lihue, HI $9.36 $0.00 – $578.09 16,708 4
Euclid, OH $2.91 $0.00 – $17.74 16,661 11
Gretna, LA $3.77 $0.00 – $53.21 16,625 38
Placentia, CA $8.77 $8.77 – $8.77 16,624 1
South Hill, VA $4.63 $0.04 – $66.75 16,607 6

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.