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

#4106 of 11K

J0134

HCPCS Procedure Code

HCPCS code J0134 is the #4,106 most-billed Medicaid procedure code, with $842K in payments across 164K claims from 2018–2024. The national median cost per claim is $1.93. Costs vary widely — the 90th percentile is $15.57 per claim, 8.1× the median.

Total Paid

$842K

0.00% of all spending

Total Claims

164K

Providers

313

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for J0134? Based on 233 providers billing this code nationally.

Median

$1.93

Average

$8.39

Std Dev

$24.62

Max

$202.90

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.30
Median
$1.93
p75
$5.48
p90
$15.57
p95
$37.45
p99
$159.35

50% of providers bill between $0.30 and $5.48 per claim for this code.

90% bill between $0.04 and $15.57.

Top 1% bill above $159.35.

About This Procedure

HCPCS code J0134 was billed by 313 providers across 164K claims, totaling $842K in Medicaid payments from 2018–2024. This code was used for 135K 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

$1.93

Providers Billing

233

National Spending

$842K

Avg/Median Ratio

4.35×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J0134

#ProviderTotal Paid
11467459776$240K
2Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$113K
3Stanford Health Care

Stanford, CA · General Acute Care Hospital

$30K
4Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$28K
51134274897$26K
6Alameda Health System

Oakland, CA · General Acute Care Hospital

$25K
7Regents Of The University Of California

Sacramento, CA · General Acute Care Hospital

$25K
81952723967$24K
91144389941$17K
10Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$16K
111366446767$14K
12Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$13K
13Women & Infants Hospital Of Rhode Island

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

$12K
14University Hospital

Newark, NJ · General Acute Care Hospital

$12K
151407800436$11K
161376698043$10K
17Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$10K
18Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$10K
19The Lowell General Hospital

Lowell, MA · Pharmacy, Institutional Pharmacy

$7K
20Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$7K

Showing top 20 of 313 providers billing this code