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

#9250 of 11K

J7615

HCPCS Procedure Code

HCPCS code J7615 is the #9,250 most-billed Medicaid procedure code, with $168 in payments across 1,069 claims from 2018–2024. The national median cost per claim is $2.74.

Total Paid

$168

0.00% of all spending

Total Claims

1,069

Providers

4

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for J7615? Based on 2 providers billing this code nationally.

Median

$2.74

Average

$2.74

Std Dev

$1.43

Max

$3.75

Percentile Distribution (Cost per Claim)

p10
$1.93
p25
$2.23
Median
$2.74
p75
$3.24
p90
$3.55
p95
$3.65
p99
$3.73

50% of providers bill between $2.23 and $3.24 per claim for this code.

90% bill between $1.93 and $3.55.

Top 1% bill above $3.73.

About This Procedure

HCPCS code J7615 was billed by 4 providers across 1,069 claims, totaling $168 in Medicaid payments from 2018–2024. This code was used for 974 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

$2.74

Providers Billing

2

National Spending

$168

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.