Drugs codes J0013 to J0911 with Medicaid rates by state

224 drugs codes from J0013 to J0911 carry a published Medicaid rate in ten or more states. The median shown is across those states' unmodified published rates; open a code for the full state-by-state table with percent of Medicare and prior-authorization flags.

CodeDescriptionStatesMedian rate
J0013Esketamine, nasal spray, 1 mg15$15.76
J0120Injection, tetracycline, up to 250 mg10$9.85
J0121Injection, omadacycline, 1 mg30$4.14
J0122Injection, eravacycline, 1 mg31$1.29
J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)32$45.85
J0130Injection abciximab, 10 mg13$1,397.26
J0131Injection, acetaminophen, not otherwise specified,10 mg22$0.05
J0132Injection, acetylcysteine, 100 mg28$0.39
J0133Injection, acyclovir, 5 mg29$0.04
J0134Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg25$0.05
J0136Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg24$0.05
J0137Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg24$0.05
J0138Injection, acetaminophen 10 mg and ibuprofen 3 mg25$0.09
J0139Injection, adalimumab, 1 mg16$91.72
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)27$0.46
J0162Injection, epinephrine (fresenius), not therapeutically equivalent to j0165, 0.1 mg22$0.41
J0163Injection, epinephrine in sodium chloride (endo), 0.1 mg22$0.61
J0164Injection, epinephrine in sodium chloride (baxter), 0.1 mg21$0.91
J0165Injection, epinephrine, not otherwise specified, 0.1 mg23$0.31
J0166Injection, epinephrine (bpi), not therapeutically equivalent to j0165, 0.1 mg19$0.67
J0167Injection, epinephrine (hospira), not therapeutically equivalent to j0165, 0.1 mg23$1.42
J0168Injection, epinephrine (international medication systems), not therapeutically equivalent to j0165, 0.1 mg23$2.56
J0169Injection, epinephrine (adrenalin), not therapeutically equivalent to j0165, 0.1 mg22$0.86
J0174Lecanemab-irmb, for intravenous injection, 1 mg27$1.34
J0175Injection, donanemab-azbt, 2 mg27$4.17
J0177Injection, aflibercept hd, 1 mg30$301.18
J0178Injection, aflibercept, 1 mg32$743.61
J0179Injection, brolucizumab-dbll, 1 mg30$353.07
J0180Injection, agalsidase beta, 1 mg31$230.32
J0184Injection, amisulpride, 1 mg24$9.54
J0185Injection, aprepitant, 1 mg33$1.65
J0202Injection, alemtuzumab, 1 mg33$2,447.10
J0206Injection, allopurinol sodium, 1 mg28$4.40
J0207Injection, amifostine, 500 mg21$677.69
J0208Injection, sodium thiosulfate (pedmark), 100 mg26$94.82
J0210Injection, methyldopate hcl, up to 250 mg17$40.00
J0211Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)11$2.17
J0216Injection, alfentanil hydrochloride, 500 micrograms11$2.57
J0217Injection, velmanase alfa-tycv, 1 mg29$465.23
J0218Injection, olipudase alfa-rpcp, 1 mg28$395.52
J0219Injection, avalglucosidase alfa-ngpt, 4 mg29$81.30
J0220Injection, alglucosidase alfa, 10 mg, not otherwise specified16$198.67
J0221Injection, alglucosidase alfa, (lumizyme), 10 mg32$207.39
J0222Injection, patisiran, 0.1 mg30$99.98
J0223Injection, givosiran, 0.5 mg29$120.69
J0224Injection, lumasiran, 0.5 mg26$328.02
J0225Injection, vutrisiran, 1 mg27$5,009.56
J0248Injection, remdesivir, 1 mg30$6.99
J0256Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg31$5.13
J0257Injection, alpha 1 proteinase inhibitor (human), (glassia), 10 mg31$5.58
J0270Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)12$0.69
J0278Injection, amikacin sulfate, 100 mg29$0.61
J0280Injection, aminophyllin, up to 250 mg29$11.16
J0281Injection, aminocaproic acid, 1 gram25$1.59
J0282Injection, amiodarone hydrochloride, 30 mg22$0.40
J0283Injection, amiodarone hydrochloride (nexterone), 30 mg26$2.45
J0285Injection, amphotericin b, 50 mg30$42.53
J0287Injection, amphotericin b lipid complex, 10 mg28$10.30
J0289Injection, amphotericin b liposome, 10 mg33$20.72
J0290Injection, ampicillin sodium, 500 mg30$0.61
J0291Injection, plazomicin, 5 mg31$3.51
J0295Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm30$1.45
J0300Injection, amobarbital, up to 125 mg22$147.29
J0330Injection, succinylcholine chloride, up to 20 mg25$0.35
J0348Injection, anidulafungin, 1 mg29$0.49
J0349Injection, rezafungin, 1 mg28$10.82
J0360Injection, hydralazine hcl, up to 20 mg30$3.60
J0364Injection, apomorphine hydrochloride, 1 mg23$34.72
J0390Injection, chloroquine hydrochloride, up to 250 mg10$16.93
J0391Injection, artesunate, 1 mg22$50.29
J0400Injection, aripiprazole, intramuscular, 0.25 mg15$0.76
J0401Injection, aripiprazole (abilify maintena), 1 mg32$7.28
J0402Injection, aripiprazole (abilify asimtufii), 1 mg29$6.03
J0456Injection, azithromycin, 500 mg29$1.89
J0457Injection, aztreonam, 100 mg26$2.27
J0458Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)26$1.71
J0461Injection, atropine sulfate, 0.01 mg28$0.11
J0462Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg22$0.13
J0463Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg17$0.02
J0470Injection, dimercaprol, per 100 mg19$56.42
J0475Injection, baclofen, 10 mg33$181.47
J0476Injection, baclofen, 50 mcg for intrathecal trial30$43.84
J0480Injection, basiliximab, 20 mg28$4,781.07
J0485Injection, belatacept, 1 mg31$3.89
J0490Injection, belimumab, 10 mg32$57.16
J0491Injection, anifrolumab-fnia, 1 mg32$18.34
J0500Injection, dicyclomine hcl, up to 20 mg30$9.24
J0515Injection, benztropine mesylate, per 1 mg29$13.54
J0517Injection, benralizumab, 1 mg31$165.56
J0525Injection, cefotetan disodium, 10 mg15$0.24
J0528Injection, fosfomycin disodium, 20 mg15$0.61
J0558Injection, penicillin g benzathine and penicillin g procaine, 100,000 units32$19.52
J0561Injection, penicillin g benzathine, 100,000 units32$31.97
J0565Injection, bezlotoxumab, 10 mg32$39.83
J0567Injection, cerliponase alfa, 1 mg20$119.58
J0571Buprenorphine, oral, 1 mg18$0.47
J0572Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine18$1.93
J0573Buprenorphine/naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine17$6.12
J0574Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine17$3.48
J0575Buprenorphine/naloxone, oral, greater than 10 mg buprenorphine17$12.27
J0577Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy29$428.66
J0578Injection, buprenorphine extended release (brixadi), greater than 7 days and up to 28 days of therapy29$1,714.63
J0582Injection, bivalirudin (endo), not therapeutically equivalent to j0583, 1 mg22$0.15
J0583Injection, bivalirudin, 1 mg26$0.17
J0584Injection, burosumab-twza 1 mg28$498.02
J0585Injection, onabotulinumtoxina, 1 unit32$6.51
J0586Injection, abobotulinumtoxina, 5 units31$8.86
J0587Injection, rimabotulinumtoxinb, 100 units32$13.29
J0588Injection, incobotulinumtoxin a, 1 unit31$5.29
J0589Injection, daxibotulinumtoxina-lanm, 1 unit24$3.07
J0592Injection, buprenorphine hydrochloride, 0.1 mg25$4.47
J0593Injection, lanadelumab-flyo, 1 mg (code may be used for medicare when drug administered under direct supervision of a physician, not for use when drug is self-administered)28$87.19
J0594injection, busulfan, 1 mg29$1.03
J0595Injection, butorphanol tartrate, 1 mg29$10.50
J0596Injection, c1 esterase inhibitor (recombinant), ruconest, 10 units32$36.78
J0597Injection, c-1 esterase inhibitor (human), berinert, 10 units31$75.96
J0598Injection, c-1 esterase inhibitor (human), cinryze, 10 units31$65.63
J0599Injection, c-1 esterase inhibitor (human), (haegarda), 10 units24$11.73
J0600Injection, edetate calcium disodium, up to 1000 mg28$6,189.49
J0601Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)10$0.01
J0602Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)10$0.03
J0603Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)10$0.04
J0604Cinacalcet, oral, 1 mg, (for esrd on dialysis)13$0.02
J0605Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)10$0.18
J0606Injection, etelcalcetide, 0.1 mg22$4.03
J0607Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)10$0.03
J0609Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)10$0.11
J0612Injection, calcium gluconate, not otherwise specified, 10 mg27$0.03
J0613Injection, calcium gluconate (wg critical care), not therapeutically equivalent to j0612, 10 mg25$0.08
J0614Injection, treosulfan, 50 mg25$32.03
J0616Injection, metoprolol tartrate, 1 mg22$0.15
J0618Injection, calcium chloride, 2 mg12$0.03
J0620Injection, calcium glycerophosphate and calcium lactate, per 10 ml10$8.96
J0630Injection, calcitonin salmon, up to 400 units30$910.54
J0636Injection, calcitriol, 0.1 mcg27$0.81
J0637Injection, caspofungin acetate, 5 mg29$3.48
J0638Injection, canakinumab, 1 mg31$147.74
J0640Injection, leucovorin calcium, per 50 mg31$3.04
J0641Injection, levoleucovorin, not otherwise specified, 0.5 mg30$0.05
J0642Injection, levoleucovorin (khapzory), 0.5 mg28$1.30
J0650Injection, levothyroxine sodium, not otherwise specified, 10 mcg25$5.98
J0651Injection, levothyroxine sodium (fresenius kabi), not therapeutically equivalent to j0650, 10 mcg27$6.84
J0652Injection, levothyroxine sodium (hikma), not therapeutically equivalent to j0650, 10 mcg25$6.32
J0654Injection, liothyronine, 1 mcg17$40.80
J0665Injection, bupivicaine, not otherwise specified, 0.5 mg26$0.01
J0666Injection, bupivacaine liposome, 1 mg26$1.45
J0668Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg15$0.79
J0670Injection, mepivacaine hydrochloride, per 10 ml27$4.14
J0675Injection, carboprost tromethamine, 0.1 mg17$19.27
J0681Injection, ceftobiprole medocaril sodium, 3 mg14$1.10
J0687Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg28$0.74
J0688Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg28$0.85
J0689Injection, cefazolin sodium (baxter), not therapeutically equivalent to j0690, 500 mg28$1.29
J0690Injection, cefazolin sodium, 500 mg30$0.80
J0691Injection, lefamulin, 1 mg19$0.72
J0692Injection, cefepime hydrochloride, 500 mg30$1.29
J0694Injection, cefoxitin sodium, 1 gm30$4.29
J0695Injection, ceftolozane 50 mg and tazobactam 25 mg29$8.95
J0696Injection, ceftriaxone sodium, per 250 mg31$0.42
J0697Injection, sterile cefuroxime sodium, per 750 mg30$2.04
J0698Injection, cefotaxime sodium, per gm25$5.03
J0699Injection, cefiderocol, 10 mg27$2.42
J0701Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg28$6.02
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg30$7.13
J0703Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg27$4.89
J0706Injection, caffeine citrate, 5 mg21$0.83
J0712Injection, ceftaroline fosamil, 10 mg31$4.24
J0713Injection, ceftazidime, per 500 mg29$1.44
J0714Injection, ceftazidime and avibactam, 0.5 g/0.125 g32$104.71
J0716Injection, centruroides immune f(ab)2, up to 120 milligrams16$5,204.13
J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)31$3.79
J0720Injection, chloramphenicol sodium succinate, up to 1 gm29$48.65
J0725Injection, chorionic gonadotropin, per 1,000 usp units29$15.07
J0735Injection, clonidine hydrochloride, 1 mg29$15.65
J0736Injection, clindamycin phosphate, 300 mg26$1.97
J0737Injection, clindamycin phosphate (baxter), not therapeutically equivalent to j0736, 300 mg24$2.24
J0738Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)25$16.08
J0739Injection, cabotegravir, 1mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)28$7.20
J0740Injection, cidofovir, 375 mg30$535.74
J0741Injection, cabotegravir and rilpivirine, 2mg/3mg30$24.16
J0742Injection, imipenem 4 mg, cilastatin 4 mg and relebactam 2 mg27$2.60
J0743Injection, cilastatin sodium; imipenem, per 250 mg29$6.52
J0744Injection, ciprofloxacin for intravenous infusion, 200 mg29$1.72
J0745Injection, codeine phosphate, per 30 mg12$1.35
J0750Emtricitabine 200mg and tenofovir disoproxil fumarate 300mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)19$1.28
J0751Emtricitabine 200mg and tenofovir alafenamide 25mg, oral, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment of hiv)21$71.42
J0752Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)22$620.91
J0759Injection, clevidipine butyrate, 1 mg18$2.85
J0770Injection, colistimethate sodium, up to 150 mg29$14.49
J0775Injection, collagenase, clostridium histolyticum, 0.01 mg31$75.91
J0780Injection, prochlorperazine, up to 10 mg31$2.76
J0791Injection, crizanlizumab-tmca, 5 mg31$129.59
J0801Injection, corticotropin (acthar gel), up to 40 units27$4,133.45
J0802Injection, corticotropin (ani), up to 40 units28$3,573.58
J0834Injection, cosyntropin, 0.25 mg30$18.73
J0840Injection, crotalidae polyvalent immune fab (ovine), up to 1 gram28$1,906.90
J0841Injection, crotalidae immune f(ab')2 (equine), 120 mg25$2,928.73
J0850Injection, cytomegalovirus immune globulin intravenous (human), per vial30$1,809.11
J0870Injection, imetelstat, 1 mg28$58.30
J0872Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg27$0.04
J0873Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg26$0.04
J0874Injection, daptomycin (baxter), not therapeutically equivalent to j0878, 1 mg23$0.06
J0875Injection, dalbavancin, 5 mg33$14.82
J0877Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg26$0.06
J0878Injection, daptomycin, 1 mg28$0.03
J0879Injection, difelikefalin, 0.1 microgram, (for esrd on dialysis)18$0.23
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)33$2.93
J0882Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)32$2.95
J0883Injection, argatroban, 1 mg (for non-esrd use)24$0.86
J0884Injection, argatroban, 1 mg (for esrd on dialysis)21$0.86
J0885Injection, epoetin alfa, (for non-esrd use), 1000 units33$6.88
J0887Injection, epoetin beta, 1 microgram, (for esrd on dialysis)24$1.22
J0888Injection, epoetin beta, 1 microgram, (for non esrd use)25$1.21
J0891Injection, argatroban (accord), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)26$1.82
J0892Injection, argatroban (accord), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)23$1.82
J0893Injection, decitabine (sun pharma), not therapeutically equivalent to j0894, 1 mg26$0.78
J0894Injection, decitabine, 1 mg31$1.06
J0895Injection, deferoxamine mesylate, 500 mg30$10.02
J0896Injection, luspatercept-aamt, 0.25 mg30$42.77
J0897Injection, denosumab, 1 mg33$29.51
J0898Injection, argatroban (auromedics), not therapeutically equivalent to j0883, 1 mg (for non-esrd use)25$1.45
J0899Injection, argatroban (auromedics), not therapeutically equivalent to j0884, 1 mg (for esrd on dialysis)22$1.45
J0901Vadadustat, oral, 1 mg (for esrd on dialysis)14$0.14
J0911Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)18$8.33

Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.