J1100
HCPCS Procedure Code
HCPCS code J1100 is the #918 most-billed Medicaid procedure code, with $58.7M in payments across 17.4M claims from 2018–2024. The national median cost per claim is $0.52. Costs vary widely — the 90th percentile is $4.79 per claim, 9.2× the median.
Total Paid
$58.7M
0.01% of all spending
Total Claims
17.4M
Providers
9K
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J1100? Based on 8K providers billing this code nationally.
Median
$0.52
Average
$2.98
Std Dev
$17.05
Max
$650.61
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.16 and $1.25 per claim for this code.
90% bill between $0.04 and $4.79.
Top 1% bill above $40.66.
About This Procedure
HCPCS code J1100 was billed by 9K providers across 17.4M claims, totaling $58.7M in Medicaid payments from 2018–2024. This code was used for 14.2M 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
$0.52
Providers Billing
8K
National Spending
$58.7M
Avg/Median Ratio
5.73×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1100
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $4.9M |
| 2 | 1881793750 | $3.7M |
| 3 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $3.3M |
| 4 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $1.6M |
| 5 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $1.2M |
| 6 | 1275651515 | $932K |
| 7 | 1013332014 | $782K |
| 8 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $655K |
| 9 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $638K |
| 10 | 1508147810 | $519K |
| 11 | Yukon-kuskokwim Health Corporation Bethel, AK · General Acute Care Hospital Rural | $515K |
| 12 | 1457409674 | $503K |
| 13 | 1073518007 | $488K |
| 14 | 1447539374 | $468K |
| 15 | 1740648856 | $463K |
| 16 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $450K |
| 17 | 1144228446 | $438K |
| 18 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $428K |
| 19 | Upmc Children's Hospital Of Pittsburgh Pittsburgh, PA · Clinic/Center | $381K |
| 20 | 1184606600 | $379K |
Showing top 20 of 9K providers billing this code