J0178
Injection, aflibercept, 1 mg
Injection, aflibercept, 1 mg is the #241 most-billed Medicaid procedure code, with $600.0M in payments across 748K claims from 2018–2024. The national median cost per claim is $730.09.
Total Paid
$600.0M
0.05% of all spending
Total Claims
748K
Providers
726
Avg Cost/Claim
$802
National Cost Distribution
How much do providers bill per claim for J0178? Based on 701 providers billing this code nationally.
Median
$730.09
Average
$814.28
Std Dev
$523.97
Max
$5,502.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $433.57 and $1,084.94 per claim for this code.
90% bill between $290.12 and $1,458.42.
Top 1% bill above $2,407.10.
About This Procedure
HCPCS code J0178 (Injection, aflibercept, 1 mg) was billed by 726 providers across 748K claims, totaling $600.0M in Medicaid payments from 2018–2024. This code was used for 579K unique beneficiaries.
Fraud Risk Context
Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.
Source: HHS OIG Reports
Risk Assessment
Billing Statistics
Median Cost/Claim
$730.09
Providers Billing
701
National Spending
$600.0M
Avg/Median Ratio
1.12×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0178
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1104868520 | $20.8M |
| 2 | 1174557805 | $19.6M |
| 3 | 1093748071 | $18.2M |
| 4 | 1891783965 | $14.1M |
| 5 | 1215003793 | $11.7M |
| 6 | 1164578894 | $10.5M |
| 7 | 1225001654 | $10.4M |
| 8 | 1619949971 | $9.5M |
| 9 | 1902800758 | $9.3M |
| 10 | 1912991225 | $8.6M |
| 11 | 1477532174 | $8.0M |
| 12 | 1205819729 | $7.7M |
| 13 | 1083757322 | $7.4M |
| 14 | 1255322806 | $6.9M |
| 15 | 1457948564 | $6.4M |
| 16 | 1134246853 | $6.3M |
| 17 | 1407916992 | $6.0M |
| 18 | 1023199734 | $5.6M |
| 19 | 1013123595 | $5.6M |
| 20 | 1760408397 | $5.5M |
Showing top 20 of 726 providers billing this code