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

#1941 of 11K

J9202

HCPCS Procedure Code

HCPCS code J9202 is the #1,941 most-billed Medicaid procedure code, with $11.2M in payments across 24K claims from 2018–2024. The national median cost per claim is $483.75.

Total Paid

$11.2M

0.00% of all spending

Total Claims

24K

Providers

57

Avg Cost/Claim

$460

National Cost Distribution

How much do providers bill per claim for J9202? Based on 54 providers billing this code nationally.

Median

$483.75

Average

$474.36

Std Dev

$282.98

Max

$1,242.40

Percentile Distribution (Cost per Claim)

p10
$94.21
p25
$318.87
Median
$483.75
p75
$609.64
p90
$848.38
p95
$963.40
p99
$1,145.01

50% of providers bill between $318.87 and $609.64 per claim for this code.

90% bill between $94.21 and $848.38.

Top 1% bill above $1,145.01.

About This Procedure

HCPCS code J9202 was billed by 57 providers across 24K claims, totaling $11.2M in Medicaid payments from 2018–2024. This code was used for 22K 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

$483.75

Providers Billing

54

National Spending

$11.2M

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J9202

#ProviderTotal Paid
1Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$1.7M
2Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$1.3M
3City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$920K
4Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$710K
5Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$660K
6University Of California Irvine

Orange, CA · General Acute Care Hospital

$645K
7Maimonides Medical Center

Brooklyn, NY · General Acute Care Hospital

$486K
8Alivia Specialty Llc

Guaynabo, PR · Pharmacy Specialty Pharmacy

$428K
91528018389$407K
101457409674$353K
111568653780$325K
12Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$314K
13Inova Health Care Services

Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder

$280K
141295023547$256K
15Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$244K
161457361271$217K
17Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$193K
18The Cooper Health System

Camden, NJ · General Acute Care Hospital

$185K
19Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$148K
20Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$143K

Showing top 20 of 57 providers billing this code