NEVVI Medicare utilization intelligence
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Market snapshot

Nationwide CY2024

Medicare Part B FFS · CY2024 · as published by CMS
J1644 Injection, heparin sodium, per 1000 units HCPCS · Treatment
Classification Treatment › Injections and Infusions (nononcologic) › Injection - Anticoagulant (CMS RBCS)
First observed 2013 — start of our 12-year window; the code predates it
National scale 247,119 services ▼ 6.2% YoY · 4,629 beneficiaries (CY2024, Medicare FFS)
Medicare paid $46K · $0.19 avg / service, national
CMS descriptor · RBCS classification · Medicare Part B physician/supplier claims, 12-year window
Billing groups

74

Named groups billing this code
Named-group FFS services

162,611

Attributable volume · fee-for-service
FFS of Medicare

49%

Payer-mix frame
Services · year over year
Services YoY

-6.2%

FFS enrollment -2.2%
Volume, not care. A shrinking fee-for-service denominator is not a shrinking market.
Estimated all-Medicare volume estimate
FFS + estimated MA

~323,073 services

162,611 observed fee-for-service (50%) · ~160,462 estimated Medicare Advantage.

Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale
Top states — J1644 (CY2024)
CA 67,764 PA 26,523 FL 23,276 AL 19,707 TN 19,579

Disclosed Medicare fee-for-service services by billing state; open a bar for that state's ranked market.

Billed → allowed → paid
Named-group submitted charges
$512K
Named-group allowed amount
$39K
Named-group Medicare payments
$30K
Avg charge / svc
$3
Avg allowed / svc
$0
Avg payment / svc
$0
Totals are named-group (attributable) sums. Allowed is Medicare’s fee-schedule recognized price — what CMS recognizes, before the 80% Medicare pays.
Average charge per group
$0 74 groups · avg submitted charge / service $120
Market analyticsPlatform Methods →

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Data year: CY2024 CY2023 CY2022  CY2021  CY2020 
# Physician group City St Specialty Providers J1644 svcs Submitted charges Avg charge Medicare $ Share* Phone
1 SCRIPPS HEALTH LA JOLLA CA PHYSICIAN ASSISTANT 1431 27,140 $16,827 $1 40.1% (858) 455-9100
2 KANSAS CITY WOMENS CLINIC GROUP LLC OVERLAND PARK KS OBSTETRICS/GYNECOLOGY 2 12,263 $12,263 $1 87.6% (913) 498-6000
3 UROLOGIC SPECIALISTS OF OKLAHOMA INC TULSA OK UROLOGY 44 10,852 $54,228 $5 74.6% (918) 749-8765
4 WELLSPAN MEDICAL GROUP YORK PA PHYSICIAN ASSISTANT 2312 7,280 $29,120 $4 27.4% —
5 MULTICARE HEALTH SYSTEM GIG HARBOR WA NURSE PRACTITIONER 2289 6,880 $6,880 $1 74.7% —
That's the top 5 of 74 groups. The platform ranks the whole market — code baskets, benchmarks, and the full ranked list. the full ranking is part of the market analytics platform — built, not launched yet. Notify me at launch →

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →