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

#4693 of 11K

J2941

HCPCS Procedure Code

HCPCS code J2941 is the #4,693 most-billed Medicaid procedure code, with $448K in payments across 15K claims from 2018–2024. The national median cost per claim is $163.62. Costs vary widely — the 90th percentile is $351.79 per claim, 2.2× the median.

Total Paid

$448K

0.00% of all spending

Total Claims

15K

Providers

10

Avg Cost/Claim

$31

National Cost Distribution

How much do providers bill per claim for J2941? Based on 6 providers billing this code nationally.

Median

$163.62

Average

$185.11

Std Dev

$163.24

Max

$426.91

Percentile Distribution (Cost per Claim)

p10
$39.92
p25
$46.61
Median
$163.62
p75
$275.38
p90
$351.79
p95
$389.35
p99
$419.39

50% of providers bill between $46.61 and $275.38 per claim for this code.

90% bill between $39.92 and $351.79.

Top 1% bill above $419.39.

About This Procedure

HCPCS code J2941 was billed by 10 providers across 15K claims, totaling $448K in Medicaid payments from 2018–2024. This code was used for 7,088 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

$163.62

Providers Billing

6

National Spending

$448K

Avg/Median Ratio

1.13×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J2941

#ProviderTotal Paid
1Optum Infusion Services 308 Llc

Chandler, AZ · Pharmacy Home Infusion Therapy Pharmacy

$326K
21992786495$89K
31295746709$15K
41215124797$15K
51629116645$2K
61942836424$741
71013919240$0
81619478047$0
91669617197$0
101982901195$0

Showing top 10 of 10 providers billing this code

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