J1745
Injection, infliximab, excludes biosimilar, 10 mg
Injection, infliximab, excludes biosimilar, 10 mg is the #292 most-billed Medicaid procedure code, with $484.9M in payments across 253K claims from 2018–2024. The national median cost per claim is $1,587.53. Costs vary widely — the 90th percentile is $3,983.11 per claim, 2.5× the median.
Total Paid
$484.9M
0.04% of all spending
Total Claims
253K
Providers
305
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for J1745? Based on 293 providers billing this code nationally.
Median
$1,587.53
Average
$1,971.87
Std Dev
$1,599.17
Max
$11,199.37
Percentile Distribution (Cost per Claim)
50% of providers bill between $995.85 and $2,549.75 per claim for this code.
90% bill between $475.84 and $3,983.11.
Top 1% bill above $7,858.59.
About This Procedure
HCPCS code J1745 (Injection, infliximab, excludes biosimilar, 10 mg) was billed by 305 providers across 253K claims, totaling $484.9M in Medicaid payments from 2018–2024. This code was used for 193K 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
$1,587.53
Providers Billing
293
National Spending
$484.9M
Avg/Median Ratio
1.24×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1745
| # | Provider | Total Paid |
|---|---|---|
| 1 | Arthritis & Rheumatology Associates Of South Jersey Pc Vineland, NJ · Internal Medicine Rheumatology | $25.1M |
| 2 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $18.1M |
| 3 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $16.0M |
| 4 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $15.9M |
| 5 | Connecticut Children's Medical Center Hartford, CT · General Acute Care Hospital, Children | $15.1M |
| 6 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $14.8M |
| 7 | North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital | $13.2M |
| 8 | Mount Sinai Hospital New York, NY · Ambulance | $11.7M |
| 9 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $11.2M |
| 10 | 1265462659 | $10.8M |
| 11 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $10.7M |
| 12 | Children's Hospital Corporation Boston, MA · Clinic/Center | $10.4M |
| 13 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $9.6M |
| 14 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $9.5M |
| 15 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $9.0M |
| 16 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $7.9M |
| 17 | 1053412643 | $7.5M |
| 18 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $7.1M |
| 19 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $7.0M |
| 20 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $6.4M |
Showing top 20 of 305 providers billing this code