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

#409 of 11K

J1270

Injection, doxercalciferol, 1 mcg

Injection, doxercalciferol, 1 mcg is the #409 most-billed Medicaid procedure code, with $257.6M in payments across 15.5M claims from 2018–2024. The national median cost per claim is $0.73. Costs vary widely — the 90th percentile is $89.25 per claim, 122.3× the median.

Total Paid

$257.6M

0.02% of all spending

Total Claims

15.5M

Providers

1,903

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for J1270? Based on 1,501 providers billing this code nationally.

Median

$0.73

Average

$19.83

Std Dev

$49.26

Max

$456.08

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.17
Median
$0.73
p75
$4.98
p90
$89.25
p95
$136.07
p99
$241.29

50% of providers bill between $0.17 and $4.98 per claim for this code.

90% bill between $0.04 and $89.25.

Top 1% bill above $241.29.

About This Procedure

HCPCS code J1270 (Injection, doxercalciferol, 1 mcg) was billed by 1,903 providers across 15.5M claims, totaling $257.6M in Medicaid payments from 2018–2024. This code was used for 1.3M 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

$0.73

Providers Billing

1,501

National Spending

$257.6M

Avg/Median Ratio

27.16×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J1270

#ProviderTotal Paid
11003883125$5.8M
21952333205$5.0M
3Dialysis Clinic Inc

Jacksonville, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment

$4.3M
41255308722$3.6M
51841268596$3.5M
61285690248$3.5M
71538137799$3.4M
81154399491$3.2M
91942278270$3.2M
101154799948$3.1M
111043277015$3.1M
121821065947$3.1M
131942567839$3.1M
141861749194$3.0M
151245208057$2.9M
161417258245$2.7M
171518196252$2.7M
181275771891$2.7M
191417925025$2.6M
201639147259$2.5M

Showing top 20 of 1,903 providers billing this code

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