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

#6713 of 11K

J2675

HCPCS Procedure Code

HCPCS code J2675 is the #6,713 most-billed Medicaid procedure code, with $47K in payments across 998 claims from 2018–2024. The national median cost per claim is $0.99. Costs vary widely — the 90th percentile is $138.26 per claim, 139.7× the median.

Total Paid

$47K

0.00% of all spending

Total Claims

998

Providers

6

Avg Cost/Claim

$47

National Cost Distribution

How much do providers bill per claim for J2675? Based on 5 providers billing this code nationally.

Median

$0.99

Average

$46.63

Std Dev

$102.05

Max

$229.17

Percentile Distribution (Cost per Claim)

p10
$0.53
p25
$0.62
Median
$0.99
p75
$1.88
p90
$138.26
p95
$183.71
p99
$220.08

50% of providers bill between $0.62 and $1.88 per claim for this code.

90% bill between $0.53 and $138.26.

Top 1% bill above $220.08.

About This Procedure

HCPCS code J2675 was billed by 6 providers across 998 claims, totaling $47K in Medicaid payments from 2018–2024. This code was used for 474 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

$0.99

Providers Billing

5

National Spending

$47K

Avg/Median Ratio

47.10×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2675

#ProviderTotal Paid
11821074972$46K
21750467452$190
31124328273$51
41689949273$46
51164582631$24
61578753703$0

Showing top 6 of 6 providers billing this code

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