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

#3914 of 11K

J1951

HCPCS Procedure Code

HCPCS code J1951 is the #3,914 most-billed Medicaid procedure code, with $1.0M in payments across 64 claims from 2018–2024. The national median cost per claim is $15,927.12.

Total Paid

$1.0M

0.00% of all spending

Total Claims

64

Providers

1

Avg Cost/Claim

$16K

National Cost Distribution

How much do providers bill per claim for J1951? Based on 1 providers billing this code nationally.

Median

$15,927.12

Average

$15,927.12

Std Dev

Max

$15,927.12

Percentile Distribution (Cost per Claim)

p10
$15,927.12
p25
$15,927.12
Median
$15,927.12
p75
$15,927.12
p90
$15,927.12
p95
$15,927.12
p99
$15,927.12

50% of providers bill between $15,927.12 and $15,927.12 per claim for this code.

90% bill between $15,927.12 and $15,927.12.

Top 1% bill above $15,927.12.

About This Procedure

HCPCS code J1951 was billed by 1 providers across 64 claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 40 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

$15,927.12

Providers Billing

1

National Spending

$1.0M

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.