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

#7649 of 11K

J7614

HCPCS Procedure Code

HCPCS code J7614 is the #7,649 most-billed Medicaid procedure code, with $13K in payments across 8,124 claims from 2018–2024. The national median cost per claim is $0.14. Costs vary widely — the 90th percentile is $6.25 per claim, 44.6× the median.

Total Paid

$13K

0.00% of all spending

Total Claims

8,124

Providers

78

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for J7614? Based on 56 providers billing this code nationally.

Median

$0.14

Average

$1.59

Std Dev

$3.02

Max

$11.86

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.05
Median
$0.14
p75
$1.20
p90
$6.25
p95
$9.42
p99
$11.57

50% of providers bill between $0.05 and $1.20 per claim for this code.

90% bill between $0.02 and $6.25.

Top 1% bill above $11.57.

About This Procedure

HCPCS code J7614 was billed by 78 providers across 8,124 claims, totaling $13K in Medicaid payments from 2018–2024. This code was used for 6,499 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

$0.14

Providers Billing

56

National Spending

$13K

Avg/Median Ratio

11.36×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7614

#ProviderTotal Paid
1Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$5K
21740208081$1K
31649727447$993
41518068014$975
51639263189$840
61588668842$781
71043293608$610
81508859323$593
91619925633$327
10Cook Children's Medical Center

Fort Worth, TX · General Acute Care Hospital Children

$229
11Harcart Health Holdings Llc

Rockville, MD · Emergency Medicine

$217
121972823987$150
131427616002$77
141902333115$47
151326224353$36
161437259694$34
17New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$31
18Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$26
191477559433$26
20Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$21

Showing top 20 of 78 providers billing this code