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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
Rio Piedras, PR $0.19 $0.19 – $0.19 992 1
Wright Patterson Afb, OH $0.07 $0.00 – $0.09 988 6
Olympia Fields, IL $1.09 $0.00 – $36.11 987 4
Blountville, TN $1.35 $1.35 – $1.35 987 1
Mt Prospect, IL $1,150 $1,150 – $1,150 987 1
Cabot, AR $0.25 $0.00 – $4.36 986 4
New Tazewell, TN $0.59 $0.15 – $5.79 982 4
Mena, AR $1.64 $0.00 – $1.67 981 2
Santa Paula, CA $0.27 $0.27 – $0.27 981 1
Gamaliel, KY $9.10 $9.10 – $9.10 981 1
Westlake, LA $1.14 $1.14 – $1.14 980 1
New Braunfels, TX $4.55 $0.00 – $36.28 979 5
Leoma, TN $0.46 $0.35 – $0.80 979 2
Crystal Falls, MI $19.06 $19.06 – $19.06 977 1
Ville Platte, LA $1.65 $0.00 – $12.42 976 11
Sallisaw, OK $18.14 $0.46 – $20.12 976 3
Chatham, VA $5.07 $0.01 – $12.22 975 2
Santa Rosa Beach, FL $1.82 $0.00 – $16.65 973 5
Midvale, UT $1,205 $1,205 – $1,205 973 1
Heber Springs, AR $4.62 $0.00 – $24.29 972 3
Noblesville, IN $296.05 $0.00 – $1,042 970 5
Paragould, AR $0.99 $0.00 – $5.27 967 4
Kaneohe, HI $235.62 $233.74 – $238.06 965 2
North Kansas City, MO $2.13 $2.13 – $2.13 963 1
Camden, OH $0.35 $0.19 – $0.49 962 2
Lutherville, MD $132.88 $74.81 – $2,359 961 3
Colonia, NJ $38.70 $38.70 – $38.70 961 1
Duncan, OK $2.30 $0.00 – $14.89 960 6
Cinnaminson, NJ $0.00 $0.00 – $0.00 960 1
Vestal, NY $14.28 $2.01 – $59.76 958 3
Port Charlotte, FL $0.92 $0.00 – $6.96 958 11
Lakeview, MI $0.00 $0.00 – $0.00 953 1
Jefferson, LA $2.87 $2.17 – $3.23 951 2
Bellevue, NE $6.21 $0.81 – $6.28 950 2
Sebring, FL $2.90 $0.00 – $16.26 948 12
Auburndale, FL $31.94 $6.44 – $50.24 945 3
Santa Rosa, NM $3.09 $3.09 – $3.09 944 1
Idabel, OK $1.95 $0.00 – $5.96 935 5
Belmont, MS $3.40 $0.00 – $10.27 933 6
Mokena, IL $10.36 $0.17 – $10.59 931 2
Highland Park, NJ $4.78 $0.56 – $4.86 931 2
Bristol, VA $7.39 $0.38 – $10.99 930 5
Belmont, NC $4.63 $0.00 – $9.34 930 7
Gatesville, TX $1.85 $1.84 – $2.06 928 2
De Pere, WI $26.97 $0.00 – $832.19 928 4
Valparaiso, IN $21.43 $0.00 – $66.29 927 5
Powell, OH $28.30 $0.00 – $92.21 927 5
Ft Lauderdale, FL $36.15 $0.98 – $435.00 926 5
Kingston, TN $0.45 $0.01 – $0.78 923 3
Goodlettsville, TN $3.27 $0.00 – $8.62 923 3

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.