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

#6004 of 11K

J7515

HCPCS Procedure Code

HCPCS code J7515 is the #6,004 most-billed Medicaid procedure code, with $108K in payments across 6K claims from 2018–2024. The national median cost per claim is $16.46.

Total Paid

$108K

0.00% of all spending

Total Claims

6K

Providers

18

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for J7515? Based on 16 providers billing this code nationally.

Median

$16.46

Average

$16.43

Std Dev

$9.88

Max

$39.46

Percentile Distribution (Cost per Claim)

p10
$4.01
p25
$8.52
Median
$16.46
p75
$22.04
p90
$25.74
p95
$29.27
p99
$37.42

50% of providers bill between $8.52 and $22.04 per claim for this code.

90% bill between $4.01 and $25.74.

Top 1% bill above $37.42.

About This Procedure

HCPCS code J7515 was billed by 18 providers across 6K claims, totaling $108K in Medicaid payments from 2018–2024. This code was used for 5K 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

$16.46

Providers Billing

16

National Spending

$108K

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7515

#ProviderTotal Paid
11881601896$22K
21396128864$20K
31134582398$19K
41932135068$10K
51174689715$10K
61427080415$10K
7Procare Pharmacy Direct, Llc.

Monroeville, PA · Pharmacy, Community/Retail Pharmacy

$6K
81770586349$3K
91730183385$1K
101619946746$1K
111588936850$943
121821329731$914
131346242542$733
141285091330$523
151013913458$474
161417901646$458
171225230840$0
181801231642$0

Showing top 18 of 18 providers billing this code