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

#8395 of 11K

J2471

HCPCS Procedure Code

HCPCS code J2471 is the #8,395 most-billed Medicaid procedure code, with $3K in payments across 3,690 claims from 2018–2024. The national median cost per claim is $0.72. Costs vary widely — the 90th percentile is $3.48 per claim, 4.8× the median.

Total Paid

$3K

0.00% of all spending

Total Claims

3,690

Providers

46

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for J2471? Based on 32 providers billing this code nationally.

Median

$0.72

Average

$1.23

Std Dev

$1.36

Max

$4.84

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.32
Median
$0.72
p75
$1.42
p90
$3.48
p95
$4.06
p99
$4.67

50% of providers bill between $0.32 and $1.42 per claim for this code.

90% bill between $0.04 and $3.48.

Top 1% bill above $4.67.

About This Procedure

HCPCS code J2471 was billed by 46 providers across 3,690 claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 2,580 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

$0.72

Providers Billing

32

National Spending

$3K

Avg/Median Ratio

1.71×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J2471

#ProviderTotal Paid
1Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$719
2Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$581
3Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$289
41821147786$252
51447231956$180
61366896300$167
7Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$155
81255387403$140
91902839673$124
101770581894$113
11Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$92
12Dayton Osteopathic Hospital

Dayton, OH · General Acute Care Hospital

$88
13Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$46
141043215379$38
151215935366$37
16Clara Maass Medical Center

Belleville, NJ · General Acute Care Hospital

$37
17Bethesda Hospital Inc

Cincinnati, OH · General Acute Care Hospital

$36
181215927470$33
19The Toledo Hospital

Toledo, OH · Pediatrics

$29
20Trinitas Regional Medical Center

Elizabeth, NJ · General Acute Care Hospital

$23

Showing top 20 of 46 providers billing this code