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

#9385 of 11K

J0400

HCPCS Procedure Code

HCPCS code J0400 is the #9,385 most-billed Medicaid procedure code, with $36 in payments across 210 claims from 2018–2024. The national median cost per claim is $0.45.

Total Paid

$36

0.00% of all spending

Total Claims

210

Providers

3

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for J0400? Based on 1 providers billing this code nationally.

Median

$0.45

Average

$0.45

Std Dev

Max

$0.45

Percentile Distribution (Cost per Claim)

p10
$0.45
p25
$0.45
Median
$0.45
p75
$0.45
p90
$0.45
p95
$0.45
p99
$0.45

50% of providers bill between $0.45 and $0.45 per claim for this code.

90% bill between $0.45 and $0.45.

Top 1% bill above $0.45.

About This Procedure

HCPCS code J0400 was billed by 3 providers across 210 claims, totaling $36 in Medicaid payments from 2018–2024. This code was used for 187 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

$0.45

Providers Billing

1

National Spending

$36

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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