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

#4613 of 11K

J7644

HCPCS Procedure Code

HCPCS code J7644 is the #4,613 most-billed Medicaid procedure code, with $488K in payments across 372K claims from 2018–2024. The national median cost per claim is $0.20. Costs vary widely — the 90th percentile is $2.27 per claim, 11.3× the median.

Total Paid

$488K

0.00% of all spending

Total Claims

372K

Providers

408

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for J7644? Based on 282 providers billing this code nationally.

Median

$0.20

Average

$0.98

Std Dev

$2.65

Max

$21.65

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.09
Median
$0.20
p75
$0.65
p90
$2.27
p95
$4.02
p99
$16.62

50% of providers bill between $0.09 and $0.65 per claim for this code.

90% bill between $0.01 and $2.27.

Top 1% bill above $16.62.

About This Procedure

HCPCS code J7644 was billed by 408 providers across 372K claims, totaling $488K in Medicaid payments from 2018–2024. This code was used for 311K 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

$0.20

Providers Billing

282

National Spending

$488K

Avg/Median Ratio

4.90×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7644

#ProviderTotal Paid
11114081270$77K
2Cook Children's Medical Center

Fort Worth, TX · General Acute Care Hospital Children

$56K
31780748939$54K
4Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$44K
5Children's Hospital Corporation

Boston, MA · Clinic/Center

$36K
6Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$34K
71003970260$25K
81134698418$24K
91275697435$20K
101912060740$17K
111114943610$11K
121366496937$7K
131346297843$7K
14Variety Children's Hospital

Miami, FL · General Acute Care Hospital Children

$6K
151811946734$5K
161912133315$5K
17Upmc Children's Hospital Of Pittsburgh

Pittsburgh, PA · Clinic/Center

$5K
18Children's Hospital

Washington, DC · General Acute Care Hospital Children

$4K
19Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$4K
201922033547$2K

Showing top 20 of 408 providers billing this code