J9145
HCPCS Procedure Code
HCPCS code J9145 is the #2,422 most-billed Medicaid procedure code, with $5.9M in payments across 3K claims from 2018–2024. The national median cost per claim is $651.46. Costs vary widely — the 90th percentile is $3,507.54 per claim, 5.4× the median.
Total Paid
$5.9M
0.00% of all spending
Total Claims
3K
Providers
10
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for J9145? Based on 10 providers billing this code nationally.
Median
$651.46
Average
$1,630.57
Std Dev
$2,247.51
Max
$7,296.19
Percentile Distribution (Cost per Claim)
50% of providers bill between $396.68 and $2,245.53 per claim for this code.
90% bill between $50.80 and $3,507.54.
Top 1% bill above $6,917.32.
About This Procedure
HCPCS code J9145 was billed by 10 providers across 3K claims, totaling $5.9M in Medicaid payments from 2018–2024. This code was used for 1K 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
$651.46
Providers Billing
10
National Spending
$5.9M
Avg/Median Ratio
2.50×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J9145
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $3.9M |
| 2 | Mount Sinai Hospital New York, NY · Ambulance | $872K |
| 3 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $750K |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $219K |
| 5 | 1477549756 | $72K |
| 6 | 1679660617 | $33K |
| 7 | 1699986331 | $33K |
| 8 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $31K |
| 9 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $29K |
| 10 | 1164493847 | $7K |
Showing top 10 of 10 providers billing this code