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

#5421 of 11K

J2371

HCPCS Procedure Code

HCPCS code J2371 is the #5,421 most-billed Medicaid procedure code, with $203K in payments across 220K claims from 2018–2024. The national median cost per claim is $0.27. Costs vary widely — the 90th percentile is $4.11 per claim, 15.2× the median.

Total Paid

$203K

0.00% of all spending

Total Claims

220K

Providers

538

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for J2371? Based on 262 providers billing this code nationally.

Median

$0.27

Average

$1.79

Std Dev

$7.84

Max

$111.25

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.03
Median
$0.27
p75
$1.10
p90
$4.11
p95
$6.24
p99
$15.84

50% of providers bill between $0.03 and $1.10 per claim for this code.

90% bill between $0.00 and $4.11.

Top 1% bill above $15.84.

About This Procedure

HCPCS code J2371 was billed by 538 providers across 220K claims, totaling $203K in Medicaid payments from 2018–2024. This code was used for 166K 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

$0.27

Providers Billing

262

National Spending

$203K

Avg/Median Ratio

6.63×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2371

#ProviderTotal Paid
1University Hospital

Newark, NJ · General Acute Care Hospital

$63K
21700886322$28K
3Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$21K
4Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$7K
51043293608$6K
6Mount Sinai Hospital

New York, NY · Ambulance

$5K
7Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$5K
8Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$5K
91104856095$4K
10Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$3K
11Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$3K
121427055821$3K
13Stanford Health Care

Stanford, CA · General Acute Care Hospital

$3K
14Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$3K
15University Medical Center, Inc

Louisville, KY · Student in an Organized Health Care Education/Training Program

$2K
16The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$2K
171215903018$2K
18St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$2K
19Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$1K
201609858950$1K

Showing top 20 of 538 providers billing this code

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