J1456
HCPCS Procedure Code
HCPCS code J1456 is the #7,977 most-billed Medicaid procedure code, with $8K in payments across 629 claims from 2018–2024. The national median cost per claim is $6.60. Costs vary widely — the 90th percentile is $19.62 per claim, 3.0× the median.
Total Paid
$8K
0.00% of all spending
Total Claims
629
Providers
8
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for J1456? Based on 7 providers billing this code nationally.
Median
$6.60
Average
$8.73
Std Dev
$8.12
Max
$21.80
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.12 and $12.79 per claim for this code.
90% bill between $1.25 and $19.62.
Top 1% bill above $21.58.
About This Procedure
HCPCS code J1456 was billed by 8 providers across 629 claims, totaling $8K in Medicaid payments from 2018–2024. This code was used for 369 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
$6.60
Providers Billing
7
National Spending
$8K
Avg/Median Ratio
1.32×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1456
| # | Provider | Total Paid |
|---|---|---|
| 1 | Ahs Hospital Corp. Morristown, NJ · General Acute Care Hospital | $6K |
| 2 | Mercy Health - St Vincent Medical Center Llc Toledo, OH · Ambulance, Land Transport | $633 |
| 3 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $632 |
| 4 | 1144286402 | $152 |
| 5 | 1548296106 | $134 |
| 6 | 1639797913 | $33 |
| 7 | 1346244126 | $20 |
| 8 | 1366404428 | $0 |
Showing top 8 of 8 providers billing this code