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

#823 of 11K

J2405

Injection, ondansetron HCl, per one milligram

Injection, ondansetron HCl, per one milligram is the #823 most-billed Medicaid procedure code, with $71.5M in payments across 26.9M claims from 2018–2024. The national median cost per claim is $0.58. Costs vary widely — the 90th percentile is $7.81 per claim, 13.5× the median.

Total Paid

$71.5M

0.01% of all spending

Total Claims

26.9M

Providers

4K

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for J2405? Based on 4K providers billing this code nationally.

Median

$0.58

Average

$3.88

Std Dev

$15.25

Max

$293.01

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.08
Median
$0.58
p75
$2.67
p90
$7.81
p95
$14.86
p99
$45.59

50% of providers bill between $0.08 and $2.67 per claim for this code.

90% bill between $0.01 and $7.81.

Top 1% bill above $45.59.

About This Procedure

HCPCS code J2405 (Injection, ondansetron HCl, per one milligram) was billed by 4K providers across 26.9M claims, totaling $71.5M in Medicaid payments from 2018–2024. This code was used for 21.5M 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

$0.58

Providers Billing

4K

National Spending

$71.5M

Avg/Median Ratio

6.69×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2405

#ProviderTotal Paid
1Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$3.3M
2Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$2.3M
3University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$1.7M
4Optum Women's And Children's Health, Llc

Marietta, GA · Home Health

$1.6M
5West Virginia University Hospitals, Inc

Morgantown, WV · Clinical Medical Laboratory

$1.5M
61871556217$1.1M
7The Miriam Hospital

Providence, RI · General Acute Care Hospital

$1.1M
81386643294$953K
91073518007$799K
101376513754$751K
111013332014$666K
12Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$592K
131477584993$568K
14Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$560K
15University Hospital

Newark, NJ · General Acute Care Hospital

$540K
16Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$535K
171114367497$491K
181184606600$489K
19Lee Memorial Health System

Ft Myers, FL · General Acute Care Hospital

$486K
201447539374$471K

Showing top 20 of 4K providers billing this code