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

#859 of 11K

A4606

HCPCS Procedure Code

HCPCS code A4606 is the #859 most-billed Medicaid procedure code, with $66.4M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $50.63. Costs vary widely — the 90th percentile is $132.71 per claim, 2.6× the median.

Total Paid

$66.4M

0.01% of all spending

Total Claims

1.1M

Providers

288

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for A4606? Based on 279 providers billing this code nationally.

Median

$50.63

Average

$64.16

Std Dev

$65.81

Max

$633.57

Percentile Distribution (Cost per Claim)

p10
$6.37
p25
$20.30
Median
$50.63
p75
$85.94
p90
$132.71
p95
$185.57
p99
$289.95

50% of providers bill between $20.30 and $85.94 per claim for this code.

90% bill between $6.37 and $132.71.

Top 1% bill above $289.95.

About This Procedure

HCPCS code A4606 was billed by 288 providers across 1.1M claims, totaling $66.4M in Medicaid payments from 2018–2024. This code was used for 636K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$50.63

Providers Billing

279

National Spending

$66.4M

Avg/Median Ratio

1.27×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4606

#ProviderTotal Paid
1Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$4.8M
2Apple Homecare Medical Supply Llc

Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment

$3.7M
31760513923$2.9M
4Super Care Inc

City Of Industry, CA · Durable Medical Equipment & Medical Supplies

$2.2M
51861480048$2.2M
61538128293$1.7M
71912923301$1.6M
81528037538$1.6M
91477748119$1.5M
101497810048$1.5M
111013952613$1.5M
12Medco Respiratory Instruments, Inc.

Houston, TX · Durable Medical Equipment & Medical Supplies

$1.4M
131316364011$1.4M
141922103142$1.4M
15The Promptcare Companies, Inc.

King Of Prussia, PA · Durable Medical Equipment & Medical Supplies

$1.3M
161073680799$1.3M
171942365598$1.2M
18Medcare Equipment Company, Llc

Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$1.2M
191407159817$1.2M
201750608147$1.1M

Showing top 20 of 288 providers billing this code