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#1133 of 11K

J0256

Injection, alpha one proteinase inhibitor, ten milligrams

Injection, alpha one proteinase inhibitor, ten milligrams is the #1,133 most-billed Medicaid procedure code, with $38.6M in payments across 16K claims from 2018–2024. The national median cost per claim is $2,388.81.

Total Paid

$38.6M

0.00% of all spending

Total Claims

16K

Providers

1

Avg Cost/Claim

$2K

National Cost Distribution

How much do providers bill per claim for J0256? Based on 1 providers billing this code nationally.

Median

$2,388.81

Average

$2,388.81

Std Dev

Max

$2,388.81

Percentile Distribution (Cost per Claim)

p10
$2,388.81
p25
$2,388.81
Median
$2,388.81
p75
$2,388.81
p90
$2,388.81
p95
$2,388.81
p99
$2,388.81

50% of providers bill between $2,388.81 and $2,388.81 per claim for this code.

90% bill between $2,388.81 and $2,388.81.

Top 1% bill above $2,388.81.

About This Procedure

HCPCS code J0256 (Injection, alpha one proteinase inhibitor, ten milligrams) was billed by 1 providers across 16K claims, totaling $38.6M in Medicaid payments from 2018–2024. This code was used for 4,015 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

$2,388.81

Providers Billing

1

National Spending

$38.6M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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