J9306
Injection, pertuzumab, one milligram
Injection, pertuzumab, one milligram is the #807 most-billed Medicaid procedure code, with $77.0M in payments across 25K claims from 2018–2024. The national median cost per claim is $3,571.19.
Total Paid
$77.0M
0.01% of all spending
Total Claims
25K
Providers
48
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for J9306? Based on 48 providers billing this code nationally.
Median
$3,571.19
Average
$3,800.80
Std Dev
$2,946.46
Max
$16,552.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $1,835.05 and $5,000.64 per claim for this code.
90% bill between $670.41 and $6,391.98.
Top 1% bill above $13,307.34.
About This Procedure
HCPCS code J9306 (Injection, pertuzumab, one milligram) was billed by 48 providers across 25K claims, totaling $77.0M in Medicaid payments from 2018–2024. This code was used for 14K 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
$3,571.19
Providers Billing
48
National Spending
$77.0M
Avg/Median Ratio
1.06×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9306
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $14.1M |
| 2 | 1003989831 | $9.2M |
| 3 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $5.7M |
| 4 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $5.1M |
| 5 | 1770690695 | $4.8M |
| 6 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $4.3M |
| 7 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $3.7M |
| 8 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $3.7M |
| 9 | 1558575746 | $2.5M |
| 10 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $2.5M |
| 11 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $2.3M |
| 12 | University Of California Irvine Orange, CA · General Acute Care Hospital | $1.9M |
| 13 | Best Option Healthcare Puerto Rico Llc San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy | $1.8M |
| 14 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $1.7M |
| 15 | 1528018389 | $1.4M |
| 16 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $1.3M |
| 17 | 1538157508 | $1.2M |
| 18 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $965K |
| 19 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $893K |
| 20 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $772K |
Showing top 20 of 48 providers billing this code