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

#4064 of 11K

J9047

HCPCS Procedure Code

HCPCS code J9047 is the #4,064 most-billed Medicaid procedure code, with $877K in payments across 183 claims from 2018–2024. The national median cost per claim is $4,654.98.

Total Paid

$877K

0.00% of all spending

Total Claims

183

Providers

3

Avg Cost/Claim

$5K

National Cost Distribution

How much do providers bill per claim for J9047? Based on 2 providers billing this code nationally.

Median

$4,654.98

Average

$4,654.98

Std Dev

$5,005.98

Max

$8,194.75

Percentile Distribution (Cost per Claim)

p10
$1,823.17
p25
$2,885.10
Median
$4,654.98
p75
$6,424.87
p90
$7,486.79
p95
$7,840.77
p99
$8,123.95

50% of providers bill between $2,885.10 and $6,424.87 per claim for this code.

90% bill between $1,823.17 and $7,486.79.

Top 1% bill above $8,123.95.

About This Procedure

HCPCS code J9047 was billed by 3 providers across 183 claims, totaling $877K in Medicaid payments from 2018–2024. This code was used for 66 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

$4,654.98

Providers Billing

2

National Spending

$877K

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.