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

#7098 of 11K

J9071

HCPCS Procedure Code

HCPCS code J9071 is the #7,098 most-billed Medicaid procedure code, with $28K in payments across 149 claims from 2018–2024. The national median cost per claim is $268.93.

Total Paid

$28K

0.00% of all spending

Total Claims

149

Providers

2

Avg Cost/Claim

$190

National Cost Distribution

How much do providers bill per claim for J9071? Based on 2 providers billing this code nationally.

Median

$268.93

Average

$268.93

Std Dev

$302.50

Max

$482.83

Percentile Distribution (Cost per Claim)

p10
$97.81
p25
$161.98
Median
$268.93
p75
$375.88
p90
$440.05
p95
$461.44
p99
$478.55

50% of providers bill between $161.98 and $375.88 per claim for this code.

90% bill between $97.81 and $440.05.

Top 1% bill above $478.55.

About This Procedure

HCPCS code J9071 was billed by 2 providers across 149 claims, totaling $28K in Medicaid payments from 2018–2024. This code was used for 79 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

$268.93

Providers Billing

2

National Spending

$28K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.