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

#1122 of 11K

J1447

HCPCS Procedure Code

HCPCS code J1447 is the #1,122 most-billed Medicaid procedure code, with $39.3M in payments across 16K claims from 2018–2024. The national median cost per claim is $171.93. Costs vary widely — the 90th percentile is $2,372.88 per claim, 13.8× the median.

Total Paid

$39.3M

0.00% of all spending

Total Claims

16K

Providers

12

Avg Cost/Claim

$2K

National Cost Distribution

How much do providers bill per claim for J1447? Based on 12 providers billing this code nationally.

Median

$171.93

Average

$585.59

Std Dev

$1,018.55

Max

$2,908.80

Percentile Distribution (Cost per Claim)

p10
$115.57
p25
$122.69
Median
$171.93
p75
$213.41
p90
$2,372.88
p95
$2,744.43
p99
$2,875.93

50% of providers bill between $122.69 and $213.41 per claim for this code.

90% bill between $115.57 and $2,372.88.

Top 1% bill above $2,875.93.

About This Procedure

HCPCS code J1447 was billed by 12 providers across 16K claims, totaling $39.3M in Medicaid payments from 2018–2024. This code was used for 2K 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

$171.93

Providers Billing

12

National Spending

$39.3M

Avg/Median Ratio

3.41×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J1447

#ProviderTotal Paid
11740648856$39.0M
21063500833$119K
31164493847$55K
41548261308$49K
5Multicare Health System

Tacoma, WA · Community/Behavioral Health

$32K
61548361413$24K
7The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$14K
81376624981$6K
91700821808$6K
101518912609$5K
111477549756$3K
121427007848$2K

Showing top 12 of 12 providers billing this code