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#7107 of 11K

J9074

HCPCS Procedure Code

HCPCS code J9074 is the #7,107 most-billed Medicaid procedure code, with $28K in payments across 120 claims from 2018–2024. The national median cost per claim is $246.84.

Total Paid

$28K

0.00% of all spending

Total Claims

120

Providers

3

Avg Cost/Claim

$233

National Cost Distribution

How much do providers bill per claim for J9074? Based on 2 providers billing this code nationally.

Median

$246.84

Average

$246.84

Std Dev

$109.25

Max

$324.09

Percentile Distribution (Cost per Claim)

p10
$185.04
p25
$208.22
Median
$246.84
p75
$285.47
p90
$308.64
p95
$316.37
p99
$322.55

50% of providers bill between $208.22 and $285.47 per claim for this code.

90% bill between $185.04 and $308.64.

Top 1% bill above $322.55.

About This Procedure

HCPCS code J9074 was billed by 3 providers across 120 claims, totaling $28K in Medicaid payments from 2018–2024. This code was used for 70 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

$246.84

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.