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

#3625 of 11K

98962

HCPCS Procedure Code

HCPCS code 98962 is the #3,625 most-billed Medicaid procedure code, with $1.4M in payments across 41K claims from 2018–2024. The national median cost per claim is $12.43. Costs vary widely — the 90th percentile is $442.50 per claim, 35.6× the median.

Total Paid

$1.4M

0.00% of all spending

Total Claims

41K

Providers

67

Avg Cost/Claim

$34

National Cost Distribution

How much do providers bill per claim for 98962? Based on 30 providers billing this code nationally.

Median

$12.43

Average

$99.61

Std Dev

$179.85

Max

$574.35

Percentile Distribution (Cost per Claim)

p10
$3.20
p25
$6.19
Median
$12.43
p75
$28.12
p90
$442.50
p95
$500.69
p99
$556.13

50% of providers bill between $6.19 and $28.12 per claim for this code.

90% bill between $3.20 and $442.50.

Top 1% bill above $556.13.

About This Procedure

HCPCS code 98962 was billed by 67 providers across 41K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.43

Providers Billing

30

National Spending

$1.4M

Avg/Median Ratio

8.01×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 98962

#ProviderTotal Paid
11689225351$587K
21487191201$348K
31063030419$191K
41851036123$97K
51164920963$87K
61588322515$22K
71134838352$21K
81144809369$21K
9Central Oklahoma American Indian Health Council Inc.

Oklahoma City, OK · Clinic/Center Federally Qualified Health Center (FQHC)

$15K
101407862030$6K
111447952767$5K
121679911531$3K
131710945969$2K
141871656082$2K
151710432919$2K
161063857373$1K
171730487208$1K
181417301250$1K
191952302689$993
201942596275$820

Showing top 20 of 67 providers billing this code