J1939
Injection, adalimumab-atto biosimilar, twenty milligrams
Injection, adalimumab-atto biosimilar, twenty milligrams is the #9,315 most-billed Medicaid procedure code, with $93 in payments across 249 claims from 2018–2024. The national median cost per claim is $0.15. Costs vary widely — the 90th percentile is $0.51 per claim, 3.4× the median.
Total Paid
$93
0.00% of all spending
Total Claims
249
Providers
4
Avg Cost/Claim
$0
National Cost Distribution
How much do providers bill per claim for J1939? Based on 3 providers billing this code nationally.
Median
$0.15
Average
$0.30
Std Dev
$0.26
Max
$0.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.15 and $0.38 per claim for this code.
90% bill between $0.15 and $0.51.
Top 1% bill above $0.59.
About This Procedure
HCPCS code J1939 (Injection, adalimumab-atto biosimilar, twenty milligrams) was billed by 4 providers across 249 claims, totaling $93 in Medicaid payments from 2018–2024. This code was used for 164 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
$0.15
Providers Billing
3
National Spending
$93
Avg/Median Ratio
2.00×
Highly skewed — outlier-driven
Provider Coverage
We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.