J7520
HCPCS Procedure Code
HCPCS code J7520 is the #5,274 most-billed Medicaid procedure code, with $243K in payments across 6K claims from 2018–2024. The national median cost per claim is $45.51.
Total Paid
$243K
0.00% of all spending
Total Claims
6K
Providers
15
Avg Cost/Claim
$38
National Cost Distribution
How much do providers bill per claim for J7520? Based on 13 providers billing this code nationally.
Median
$45.51
Average
$45.71
Std Dev
$21.97
Max
$74.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $28.74 and $66.27 per claim for this code.
90% bill between $24.67 and $72.01.
Top 1% bill above $74.68.
About This Procedure
HCPCS code J7520 was billed by 15 providers across 6K claims, totaling $243K in Medicaid payments from 2018–2024. This code was used for 5K 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
$45.51
Providers Billing
13
National Spending
$243K
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7520
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1619946746 | $102K |
| 2 | 1770586349 | $47K |
| 3 | 1881601896 | $36K |
| 4 | 1255634218 | $21K |
| 5 | 1134582398 | $15K |
| 6 | 1588992861 | $7K |
| 7 | 1790856458 | $4K |
| 8 | 1013913458 | $4K |
| 9 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $3K |
| 10 | 1174689715 | $3K |
| 11 | 1932135068 | $2K |
| 12 | 1730273582 | $346 |
| 13 | 1417670688 | $321 |
| 14 | 1477891893 | $0 |
| 15 | 1730183385 | $0 |
Showing top 15 of 15 providers billing this code