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

#2894 of 11K

J7620

HCPCS Procedure Code

HCPCS code J7620 is the #2,894 most-billed Medicaid procedure code, with $3.1M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $0.14. Costs vary widely — the 90th percentile is $4.03 per claim, 28.8× the median.

Total Paid

$3.1M

0.00% of all spending

Total Claims

1.1M

Providers

1,367

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for J7620? Based on 1,019 providers billing this code nationally.

Median

$0.14

Average

$2.78

Std Dev

$15.77

Max

$279.47

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.05
Median
$0.14
p75
$1.17
p90
$4.03
p95
$7.52
p99
$46.68

50% of providers bill between $0.05 and $1.17 per claim for this code.

90% bill between $0.01 and $4.03.

Top 1% bill above $46.68.

About This Procedure

HCPCS code J7620 was billed by 1,367 providers across 1.1M claims, totaling $3.1M in Medicaid payments from 2018–2024. This code was used for 914K 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

1,019

National Spending

$3.1M

Avg/Median Ratio

19.86×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7620

#ProviderTotal Paid
11780748939$708K
2University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$313K
31275697435$305K
41003970260$227K
5Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$138K
61114081270$134K
71134698418$127K
81912060740$104K
91235139312$79K
101912964768$74K
111114943610$71K
121104906569$64K
131194790055$48K
141407887003$45K
151104812684$33K
161730177668$28K
171801821376$27K
18The Cooper Health System

Camden, NJ · General Acute Care Hospital

$27K
19Super Care Inc

City Of Industry, CA · Durable Medical Equipment & Medical Supplies

$22K
201619928017$21K

Showing top 20 of 1,367 providers billing this code