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

#1914 of 11K

A4628

HCPCS Procedure Code

HCPCS code A4628 is the #1,914 most-billed Medicaid procedure code, with $11.7M in payments across 927K claims from 2018–2024. The national median cost per claim is $7.48. Costs vary widely — the 90th percentile is $19.28 per claim, 2.6× the median.

Total Paid

$11.7M

0.00% of all spending

Total Claims

927K

Providers

410

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for A4628? Based on 405 providers billing this code nationally.

Median

$7.48

Average

$10.95

Std Dev

$13.02

Max

$137.23

Percentile Distribution (Cost per Claim)

p10
$2.80
p25
$4.86
Median
$7.48
p75
$11.83
p90
$19.28
p95
$27.09
p99
$65.50

50% of providers bill between $4.86 and $11.83 per claim for this code.

90% bill between $2.80 and $19.28.

Top 1% bill above $65.50.

About This Procedure

HCPCS code A4628 was billed by 410 providers across 927K claims, totaling $11.7M in Medicaid payments from 2018–2024. This code was used for 813K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.48

Providers Billing

405

National Spending

$11.7M

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A4628

#ProviderTotal Paid
11649228909$772K
2Super Care Inc

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

$707K
31902829500$641K
41811060544$556K
51508885617$507K
61861480048$440K
7Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$304K
81891094108$259K
91083615991$226K
10Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$216K
111073692794$193K
12Apple Homecare Medical Supply Llc

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

$181K
13The Promptcare Companies, Inc.

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

$177K
141477801439$171K
151922103142$167K
161942365598$160K
171497831507$152K
181871738153$152K
191548360464$146K
201275612673$139K

Showing top 20 of 410 providers billing this code