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

#1990 of 11K

J3262

Injection, tocilizumab, one milligram

Injection, tocilizumab, one milligram is the #1,990 most-billed Medicaid procedure code, with $10.4M in payments across 11K claims from 2018–2024. The national median cost per claim is $702.69. Costs vary widely — the 90th percentile is $1,765.39 per claim, 2.5× the median.

Total Paid

$10.4M

0.00% of all spending

Total Claims

11K

Providers

35

Avg Cost/Claim

$952

National Cost Distribution

How much do providers bill per claim for J3262? Based on 34 providers billing this code nationally.

Median

$702.69

Average

$852.90

Std Dev

$672.83

Max

$2,447.94

Percentile Distribution (Cost per Claim)

p10
$67.20
p25
$266.84
Median
$702.69
p75
$1,252.60
p90
$1,765.39
p95
$2,061.39
p99
$2,351.37

50% of providers bill between $266.84 and $1,252.60 per claim for this code.

90% bill between $67.20 and $1,765.39.

Top 1% bill above $2,351.37.

About This Procedure

HCPCS code J3262 (Injection, tocilizumab, one milligram) was billed by 35 providers across 11K claims, totaling $10.4M in Medicaid payments from 2018–2024. This code was used for 6K 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

$702.69

Providers Billing

34

National Spending

$10.4M

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J3262

#ProviderTotal Paid
11992076681$1.8M
21811080526$1.7M
3Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$1.4M
41700017118$934K
51427536325$872K
61639172372$656K
71366489254$490K
81841246568$487K
91437199882$317K
10Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$296K
111073702635$267K
121588137228$165K
13Loma Linda University Children's Hospital

Loma Linda, CA · General Acute Care Hospital Children

$154K
14The Nemours Foundation

Orlando, FL · General Acute Care Hospital Children

$143K
151598875460$137K
16Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$113K
171114965779$99K
18Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$76K
19Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$44K
20Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$41K

Showing top 20 of 35 providers billing this code

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