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

#6151 of 11K

J9049

HCPCS Procedure Code

HCPCS code J9049 is the #6,151 most-billed Medicaid procedure code, with $90K in payments across 504 claims from 2018–2024. The national median cost per claim is $190.02.

Total Paid

$90K

0.00% of all spending

Total Claims

504

Providers

2

Avg Cost/Claim

$179

National Cost Distribution

How much do providers bill per claim for J9049? Based on 1 providers billing this code nationally.

Median

$190.02

Average

$190.02

Std Dev

Max

$190.02

Percentile Distribution (Cost per Claim)

p10
$190.02
p25
$190.02
Median
$190.02
p75
$190.02
p90
$190.02
p95
$190.02
p99
$190.02

50% of providers bill between $190.02 and $190.02 per claim for this code.

90% bill between $190.02 and $190.02.

Top 1% bill above $190.02.

About This Procedure

HCPCS code J9049 was billed by 2 providers across 504 claims, totaling $90K in Medicaid payments from 2018–2024. This code was used for 360 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

$190.02

Providers Billing

1

National Spending

$90K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.