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Accredo Health Group INC

Pharmacy, Community/Retail Pharmacy·Warrendale, PA·NPI: 1417915653Share
Active Billing Period:2018-01→2024-12(84 months)
Sharp billing drop in final month

Total Paid

$130.9M

$130,922,434

Total Claims

151K

Beneficiaries

78K

1.9 claims/patient

Avg Cost/Claim

$868

#882 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Accredo Health Group INC is a Pharmacy, Community/Retail Pharmacy provider based in Warrendale, PA. From the 2018–2024 period, this provider received $130.9M in Medicaid payments across 151K claims.

Why This Matters

This provider received $130.9M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 16,365 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 52% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$21.5M
-12%
2019
$18.9M
+11%
2020
$21.0M
+7%
2021
$22.5M
+4%
2022
$23.5M
-44%
2023
$13.1M
-22%
2024
$10.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (J3285) accounts for 42% of total spending.

J3285Normal range

$55.3M

13K claims · 42.2%

Your Cost: $4,291.75/claim|Median: $4,178.96
1.0× median
J7686Normal range

$12.5M

3,664 claims · 9.5%

Your Cost: $3,406.01/claim|Median: $3,406.01
1.0× median
J1559Normal range

$12.4M

9,258 claims · 9.4%

Your Cost: $1,335.72/claim|Median: $811.35
1.6× median
J7170Normal range

Emicizumab-kxwh (Hemlibra) injection, 0.5 mg

$10.7M

824 claims · 8.1%

Your Cost: $12,925.93/claim|Median: $23,418.64
0.6× median
J1569Normal range

$9.6M

5,807 claims · 7.3%

Your Cost: $1,656.90/claim|Median: $1,387.65
1.2× median
J1325Normal range

$4.9M

6,735 claims · 3.8%

Your Cost: $732.53/claim|Median: $732.53
1.0× median
J1561Normal range

$4.9M

2,902 claims · 3.7%

Your Cost: $1,689.99/claim|Median: $1,482.84
1.1× median
J1555Normal range

$4.2M

2,666 claims · 3.2%

Your Cost: $1,567.89/claim|Median: $1,277.71
1.2× median
S9347Normal range

$4.1M

15K claims · 3.1%

Your Cost: $280.34/claim|Median: $265.52
1.1× median
J7192Normal range

Factor VIII (recombinant antihemophilic factor), per IU

$3.0M

1,123 claims · 2.3%

Your Cost: $2,677.11/claim|Median: $8,137.49
0.3× median
J1575Top 1%

$3.0M

1,889 claims · 2.3%

Your Cost: $1,577.48/claim|Median: $1,577.48
1.0× median
J7340Top 1%

$1.8M

1,596 claims · 1.4%

Your Cost: $1,133.74/claim|Median: $1,133.74
1.0× median
A4222Normal range

$953K

14K claims · 0.7%

Your Cost: $66.22/claim|Median: $62.70
1.1× median
A4221Top 25%

Supplies for maintenance of drug infusion catheter

$668K

30K claims · 0.5%

Your Cost: $22.16/claim|Median: $16.19
1.4× median
S9338Normal range

$586K

6,718 claims · 0.4%

Your Cost: $87.19/claim|Median: $60.83
1.4× median
S9379Normal range

$467K

5,821 claims · 0.4%

Your Cost: $80.20/claim|Median: $70.89
1.1× median
99601Top 25%

$464K

4,186 claims · 0.4%

Your Cost: $110.94/claim|Median: $82.41
1.3× median
Q9992Normal range

$359K

210 claims · 0.3%

Your Cost: $1,708.08/claim|Median: $1,537.34
1.1× median
99602Top 10%

$306K

1,874 claims · 0.2%

Your Cost: $163.42/claim|Median: $84.91
1.9× median
K0455Normal range

$249K

7,062 claims · 0.2%

Your Cost: $35.20/claim|Median: $27.80
1.3× median
Q2052Top 1%

$119K

1,810 claims · 0.1%

Your Cost: $65.79/claim|Median: $63.97
1.0× median
Q0513Top 5%

$108K

2,183 claims · 0.1%

Your Cost: $49.52/claim|Median: $5.61
8.8× median
E0781Normal range

$99K

1,919 claims · 0.1%

Your Cost: $51.72/claim|Median: $54.38
1.0× median
K0552Normal range

$87K

7,729 claims · 0.1%

Your Cost: $11.28/claim|Median: $19.78
0.6× median
J0585Top 25%

Injection, onabotulinumtoxinA, 1 unit

$39K

39 claims · 0.0%

Your Cost: $1,002.88/claim|Median: $470.36
2.1× median
S9999Top 5%

$39K

403 claims · 0.0%

Your Cost: $96.66/claim|Median: $5.38
18.0× median
J1459Normal range

$17K

22 claims · 0.0%

Your Cost: $779.76/claim|Median: $949.14
0.8× median
S9346Normal range

$12K

259 claims · 0.0%

Your Cost: $45.41/claim|Median: $85.14
0.5× median
S0155Top 1%

$10K

35 claims · 0.0%

Your Cost: $277.72/claim|Median: $277.72
1.0× median
E0779Normal range

$6K

1,341 claims · 0.0%

Your Cost: $4.77/claim|Median: $7.60
0.6× median

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