#2490 of 11K

J7507

Tacrolimus, immediate release, oral, per milligram

Tacrolimus, immediate release, oral, per milligram is the #2,490 most-billed Medicaid procedure code, with $5.4M in payments across 623K claims from 2018–2024. The national median cost per claim is $7.69. Costs vary widely — the 90th percentile is $19.32 per claim, 2.5× the median.

Total Paid

$5.4M

0.00% of all spending

Total Claims

623K

Providers

266

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for J7507? Based on 242 providers billing this code nationally.

Median

$7.69

Average

$11.16

Std Dev

$22.86

Max

$277.79

Percentile Distribution (Cost per Claim)

p10

$1.40

p25

$3.15

Median

$7.69

p75

$14.33

p90

$19.32

p95

$22.98

p99

$38.10

50% of providers bill between $3.15 and $14.33 per claim for this code.

90% bill between $1.40 and $19.32.

Top 1% bill above $38.10.

About This Procedure

HCPCS code J7507 (Tacrolimus, immediate release, oral, per milligram) was billed by 266 providers across 623K claims, totaling $5.4M in Medicaid payments from 2018–2024. This code was used for 463K 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

$7.69

Providers Billing

242

National Spending

$5.4M

Avg/Median Ratio

1.45×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7507

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1932135068	$255K	$19.33	2.5× median	Top 10%
2	1437253168	$172K	$13.89	1.8× median	Above Median
3	1013913458	$170K	$12.93	1.7× median	Above Median
4	1619946746	$150K	$10.97	1.4× median	Above Median
5	1417901646	$144K	$9.77	1.3× median	Above Median
6	1225482490	$141K	$25.63	3.3× median	Top 10%
7	1437513876	$139K	$11.30	1.5× median	Above Median
8	1831594092	$139K	$15.76	2.1× median	Above 75th
9	1770586349	$125K	$11.58	1.5× median	Above Median
10	1801819818	$115K	$13.74	1.8× median	Above Median
11	1255634218	$112K	$6.06	0.8× median	Below Median
12	1013925122	$111K	$19.38	2.5× median	Top 10%
13	1619080942	$106K	$16.87	2.2× median	Above 75th
14	1679676639	$105K	$22.77	3.0× median	Top 10%
15	1265538664	$105K	$16.49	2.1× median	Above 75th
16	1760827414	$95K	$29.91	3.9× median	Top 10%
17	1083038368	$95K	$13.36	1.7× median	Above Median
18	1396128864	$90K	$13.78	1.8× median	Above Median
19	1790856458	$82K	$3.94	0.5× median	Below Median
20	1285091330	$81K	$8.26	1.1× median	Above Median

Showing top 20 of 266 providers billing this code

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