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

#277 of 11K

Q4081

Injection, epoetin alfa, 100 units (non-ESRD)

Injection, epoetin alfa, 100 units (non-ESRD) is the #277 most-billed Medicaid procedure code, with $508.0M in payments across 23.6M claims from 2018–2024. The national median cost per claim is $4.98. Costs vary widely — the 90th percentile is $90.55 per claim, 18.2× the median.

Total Paid

$508.0M

0.05% of all spending

Total Claims

23.6M

Providers

2,019

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for Q4081? Based on 1,736 providers billing this code nationally.

Median

$4.98

Average

$34.72

Std Dev

$192.19

Max

$7,066.98

Percentile Distribution (Cost per Claim)

p10
$0.29
p25
$1.56
Median
$4.98
p75
$17.30
p90
$90.55
p95
$139.90
p99
$423.83

50% of providers bill between $1.56 and $17.30 per claim for this code.

90% bill between $0.29 and $90.55.

Top 1% bill above $423.83.

About This Procedure

HCPCS code Q4081 (Injection, epoetin alfa, 100 units (non-ESRD)) was billed by 2,019 providers across 23.6M claims, totaling $508.0M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.98

Providers Billing

1,736

National Spending

$508.0M

Avg/Median Ratio

6.97×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for Q4081

#ProviderTotal Paid
11003883125$10.2M
21841268596$6.8M
31942278270$6.5M
41154399491$6.3M
51285690248$5.9M
61255308722$5.5M
71538137799$5.4M
81245208057$5.3M
91861749194$5.2M
101942567839$5.1M
111154799948$4.9M
121639147259$4.9M
131538487897$4.9M
141275771891$4.8M
151356319859$4.7M
161316915077$4.7M
171043277015$4.5M
181528036050$4.4M
191821065947$4.4M
201417925025$4.4M

Showing top 20 of 2,019 providers billing this code