J3415
HCPCS Procedure Code
HCPCS code J3415 is the #5,339 most-billed Medicaid procedure code, with $225K in payments across 33K claims from 2018–2024. The national median cost per claim is $4.23. Costs vary widely — the 90th percentile is $12.90 per claim, 3.0× the median.
Total Paid
$225K
0.00% of all spending
Total Claims
33K
Providers
54
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for J3415? Based on 47 providers billing this code nationally.
Median
$4.23
Average
$6.00
Std Dev
$5.61
Max
$24.59
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.07 and $8.48 per claim for this code.
90% bill between $0.52 and $12.90.
Top 1% bill above $23.42.
About This Procedure
HCPCS code J3415 was billed by 54 providers across 33K claims, totaling $225K in Medicaid payments from 2018–2024. This code was used for 15K 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
$4.23
Providers Billing
47
National Spending
$225K
Avg/Median Ratio
1.42×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J3415
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1396382685 | $44K |
| 2 | 1982929121 | $26K |
| 3 | 1174082523 | $14K |
| 4 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $14K |
| 5 | 1386187540 | $13K |
| 6 | 1447439062 | $13K |
| 7 | 1104236199 | $11K |
| 8 | 1942421979 | $9K |
| 9 | 1356301808 | $9K |
| 10 | 1760548804 | $8K |
| 11 | 1124497730 | $8K |
| 12 | 1811135247 | $7K |
| 13 | 1548722127 | $7K |
| 14 | 1669407185 | $6K |
| 15 | 1821006586 | $6K |
| 16 | 1356925960 | $6K |
| 17 | 1821669656 | $5K |
| 18 | 1184636268 | $4K |
| 19 | 1841873288 | $3K |
| 20 | 1902918279 | $3K |
Showing top 20 of 54 providers billing this code