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

#7352 of 11K

J0895

HCPCS Procedure Code

HCPCS code J0895 is the #7,352 most-billed Medicaid procedure code, with $20K in payments across 293 claims from 2018–2024. The national median cost per claim is $60.57.

Total Paid

$20K

0.00% of all spending

Total Claims

293

Providers

3

Avg Cost/Claim

$69

National Cost Distribution

How much do providers bill per claim for J0895? Based on 3 providers billing this code nationally.

Median

$60.57

Average

$53.23

Std Dev

$48.18

Max

$97.32

Percentile Distribution (Cost per Claim)

p10
$13.56
p25
$31.19
Median
$60.57
p75
$78.94
p90
$89.97
p95
$93.64
p99
$96.58

50% of providers bill between $31.19 and $78.94 per claim for this code.

90% bill between $13.56 and $89.97.

Top 1% bill above $96.58.

About This Procedure

HCPCS code J0895 was billed by 3 providers across 293 claims, totaling $20K in Medicaid payments from 2018–2024. This code was used for 61 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

$60.57

Providers Billing

3

National Spending

$20K

Avg/Median Ratio

0.88×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.