Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1184 of 11K

B4158

HCPCS Procedure Code

HCPCS code B4158 is the #1,184 most-billed Medicaid procedure code, with $34.7M in payments across 215K claims from 2018–2024. The national median cost per claim is $145.71.

Total Paid

$34.7M

0.00% of all spending

Total Claims

215K

Providers

157

Avg Cost/Claim

$161

National Cost Distribution

How much do providers bill per claim for B4158? Based on 153 providers billing this code nationally.

Median

$145.71

Average

$160.68

Std Dev

$94.14

Max

$741.56

Percentile Distribution (Cost per Claim)

p10
$73.70
p25
$110.08
Median
$145.71
p75
$192.88
p90
$251.09
p95
$298.81
p99
$485.34

50% of providers bill between $110.08 and $192.88 per claim for this code.

90% bill between $73.70 and $251.09.

Top 1% bill above $485.34.

About This Procedure

HCPCS code B4158 was billed by 157 providers across 215K claims, totaling $34.7M in Medicaid payments from 2018–2024. This code was used for 175K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$145.71

Providers Billing

153

National Spending

$34.7M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for B4158

#ProviderTotal Paid
1Option 1 Nutrition Solutions Llc

Denver, CO · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$3.9M
21871509489$2.5M
3Integra Partners Llc

Troy, MI · Orthotic Fitter

$2.4M
4Indiana University Health, Inc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$2.3M
5Medco Respiratory Instruments, Inc.

Houston, TX · Durable Medical Equipment & Medical Supplies

$1.8M
6Hhsc Wic Program

Austin, TX · Pharmacy

$1.3M
71902863434$878K
8Apple Homecare Medical Supply Llc

Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment

$802K
91306961792$751K
101407159817$721K
111043512114$648K
121871738153$620K
131679823587$587K
141780625533$576K
151801866173$545K
161184653388$509K
171194859629$496K
181013952613$484K
19Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$468K
20Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$457K

Showing top 20 of 157 providers billing this code