Q5003
Injection, infliximab-dyyb, biosimilar, 10 mg
Injection, infliximab-dyyb, biosimilar, 10 mg is the #244 most-billed Medicaid procedure code, with $589.1M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $177.99. Costs vary widely — the 90th percentile is $4,144.46 per claim, 23.3× the median.
Total Paid
$589.1M
0.05% of all spending
Total Claims
1.2M
Providers
369
Avg Cost/Claim
$473
National Cost Distribution
How much do providers bill per claim for Q5003? Based on 175 providers billing this code nationally.
Median
$177.99
Average
$1,181.82
Std Dev
$1,767.75
Max
$6,743.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $34.09 and $2,533.95 per claim for this code.
90% bill between $4.58 and $4,144.46.
Top 1% bill above $5,851.87.
About This Procedure
HCPCS code Q5003 (Injection, infliximab-dyyb, biosimilar, 10 mg) was billed by 369 providers across 1.2M claims, totaling $589.1M in Medicaid payments from 2018–2024. This code was used for 322K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$177.99
Providers Billing
175
National Spending
$589.1M
Avg/Median Ratio
6.64×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for Q5003
| # | Provider | Total Paid |
|---|---|---|
| 1 | Seasons Hospice & Palliative Care Of Maryland, Llc Columbia, MD · Hospice Care, Community Based | $84.9M |
| 2 | Gilchrist Hospice Care Inc. Towson, MD · Hospice, Inpatient | $54.6M |
| 3 | 1427051325 | $30.0M |
| 4 | 1124028204 | $29.7M |
| 5 | 1568415032 | $29.1M |
| 6 | 1437156775 | $22.1M |
| 7 | 1386622595 | $21.4M |
| 8 | 1174576656 | $20.6M |
| 9 | 1669548053 | $17.8M |
| 10 | 1366559064 | $16.9M |
| 11 | 1386667277 | $15.8M |
| 12 | 1780738757 | $15.6M |
| 13 | 1528113792 | $14.8M |
| 14 | 1982651600 | $13.9M |
| 15 | 1710064878 | $12.2M |
| 16 | 1316909203 | $10.3M |
| 17 | 1205887452 | $10.0M |
| 18 | 1205832268 | $9.7M |
| 19 | 1790739282 | $9.4M |
| 20 | 1235283151 | $9.2M |
Showing top 20 of 369 providers billing this code