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

#5167 of 11K

J1449

HCPCS Procedure Code

HCPCS code J1449 is the #5,167 most-billed Medicaid procedure code, with $271K in payments across 235 claims from 2018–2024. The national median cost per claim is $1,892.67.

Total Paid

$271K

0.00% of all spending

Total Claims

235

Providers

2

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for J1449? Based on 2 providers billing this code nationally.

Median

$1,892.67

Average

$1,892.67

Std Dev

$2,383.83

Max

$3,578.30

Percentile Distribution (Cost per Claim)

p10
$544.17
p25
$1,049.86
Median
$1,892.67
p75
$2,735.48
p90
$3,241.17
p95
$3,409.73
p99
$3,544.59

50% of providers bill between $1,049.86 and $2,735.48 per claim for this code.

90% bill between $544.17 and $3,241.17.

Top 1% bill above $3,544.59.

About This Procedure

HCPCS code J1449 was billed by 2 providers across 235 claims, totaling $271K in Medicaid payments from 2018–2024. This code was used for 203 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

$1,892.67

Providers Billing

2

National Spending

$271K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.