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

#3833 of 11K

J7611

Albuterol inhalation solution, non-concentrated, per milligram

Albuterol inhalation solution, non-concentrated, per milligram is the #3,833 most-billed Medicaid procedure code, with $1.1M in payments across 211K claims from 2018–2024. The national median cost per claim is $0.26. Costs vary widely — the 90th percentile is $4.23 per claim, 16.3× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

211K

Providers

396

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for J7611? Based on 294 providers billing this code nationally.

Median

$0.26

Average

$6.31

Std Dev

$37.49

Max

$507.14

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.12
Median
$0.26
p75
$0.82
p90
$4.23
p95
$15.31
p99
$147.50

50% of providers bill between $0.12 and $0.82 per claim for this code.

90% bill between $0.02 and $4.23.

Top 1% bill above $147.50.

About This Procedure

HCPCS code J7611 (Albuterol inhalation solution, non-concentrated, per milligram) was billed by 396 providers across 211K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 175K 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

$0.26

Providers Billing

294

National Spending

$1.1M

Avg/Median Ratio

24.27×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7611

#ProviderTotal Paid
1The Nemours Foundation

Orlando, FL · General Acute Care Hospital Children

$484K
2Cook Children's Medical Center

Fort Worth, TX · General Acute Care Hospital Children

$143K
3Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$127K
4Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$65K
5Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$50K
6Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$25K
71487699047$23K
81972503647$17K
91801821376$15K
101215903018$14K
111346297843$9K
121235196510$9K
131811946734$7K
14Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$7K
15Kern County Hospital Authority

Bakersfield, CA · General Acute Care Hospital

$7K
161104906569$6K
17The Nemours Foundation

Wilmington, DE · General Acute Care Hospital Children

$5K
181467808659$5K
19Alameda Health System

Oakland, CA · General Acute Care Hospital

$5K
201821147786$4K

Showing top 20 of 396 providers billing this code