J1426
Casimersen (Amondys 45) injection, 10 mg
Casimersen (Amondys 45) injection, 10 mg is the #865 most-billed Medicaid procedure code, with $65.6M in payments across 2K claims from 2018–2024. The national median cost per claim is $31,833.01.
Total Paid
$65.6M
0.01% of all spending
Total Claims
2K
Providers
1
Avg Cost/Claim
$32K
National Cost Distribution
How much do providers bill per claim for J1426? Based on 1 providers billing this code nationally.
Median
$31,833.01
Average
$31,833.01
Std Dev
—
Max
$31,833.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $31,833.01 and $31,833.01 per claim for this code.
90% bill between $31,833.01 and $31,833.01.
Top 1% bill above $31,833.01.
About This Procedure
HCPCS code J1426 (Casimersen (Amondys 45) injection, 10 mg) was billed by 1 providers across 2K claims, totaling $65.6M in Medicaid payments from 2018–2024. This code was used for 747 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
$31,833.01
Providers Billing
1
National Spending
$65.6M
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.