J2401
HCPCS Procedure Code
HCPCS code J2401 is the #7,206 most-billed Medicaid procedure code, with $25K in payments across 1K claims from 2018–2024. The national median cost per claim is $5.97. Costs vary widely — the 90th percentile is $25.35 per claim, 4.2× the median.
Total Paid
$25K
0.00% of all spending
Total Claims
1K
Providers
9
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for J2401? Based on 6 providers billing this code nationally.
Median
$5.97
Average
$10.44
Std Dev
$12.37
Max
$28.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.28 and $19.68 per claim for this code.
90% bill between $0.01 and $25.35.
Top 1% bill above $27.81.
About This Procedure
HCPCS code J2401 was billed by 9 providers across 1K claims, totaling $25K in Medicaid payments from 2018–2024. This code was used for 811 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
$5.97
Providers Billing
6
National Spending
$25K
Avg/Median Ratio
1.75×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J2401
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1295726362 | $21K |
| 2 | City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator | $4K |
| 3 | 1992729461 | $339 |
| 4 | Henry Ford Health St. John Hospital Chicago, IL · Clinic/Center, Ambulatory Surgical | $15 |
| 5 | 1689987166 | $1 |
| 6 | 1013566991 | $0 |
| 7 | Mainehealth Portland, ME · Emergency Medicine | $0 |
| 8 | 1952312050 | $0 |
| 9 | University Of Colorado Hospital Authority Aurora, CO · General Acute Care Hospital | $0 |
Showing top 9 of 9 providers billing this code