J0713
HCPCS Procedure Code
HCPCS code J0713 is the #8,407 most-billed Medicaid procedure code, with $3K in payments across 398 claims from 2018–2024. The national median cost per claim is $0.28. Costs vary widely — the 90th percentile is $35.88 per claim, 128.1× the median.
Total Paid
$3K
0.00% of all spending
Total Claims
398
Providers
7
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for J0713? Based on 3 providers billing this code nationally.
Median
$0.28
Average
$15.06
Std Dev
$25.74
Max
$44.79
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.20 and $22.53 per claim for this code.
90% bill between $0.15 and $35.88.
Top 1% bill above $43.90.
About This Procedure
HCPCS code J0713 was billed by 7 providers across 398 claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 231 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
$0.28
Providers Billing
3
National Spending
$3K
Avg/Median Ratio
53.79×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0713
| # | Provider | Total Paid |
|---|---|---|
| 1 | Liberty Dialysis - Hawaii Llc Honolulu, HI · Clinic/Center End-Stage Renal Disease (ESRD) Treatment | $3K |
| 2 | Brockton Hospital, Inc. Brockton, MA · General Acute Care Hospital | $48 |
| 3 | 1245214477 | $4 |
| 4 | 1699874248 | $0 |
| 5 | Variety Children's Hospital Miami, FL · General Acute Care Hospital Children | $0 |
| 6 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $0 |
| 7 | Saint Mary's Hospital, Inc. Waterbury, CT · General Acute Care Hospital | $0 |
Showing top 7 of 7 providers billing this code