J2356
HCPCS Procedure Code
HCPCS code J2356 is the #3,694 most-billed Medicaid procedure code, with $1.3M in payments across 529 claims from 2018–2024. The national median cost per claim is $1,828.61.
Total Paid
$1.3M
0.00% of all spending
Total Claims
529
Providers
9
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for J2356? Based on 9 providers billing this code nationally.
Median
$1,828.61
Average
$1,798.47
Std Dev
$1,094.15
Max
$3,459.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $1,033.63 and $2,395.85 per claim for this code.
90% bill between $552.07 and $3,068.51.
Top 1% bill above $3,420.21.
About This Procedure
HCPCS code J2356 was billed by 9 providers across 529 claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 419 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
$1,828.61
Providers Billing
9
National Spending
$1.3M
Avg/Median Ratio
0.98×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2356
| # | Provider | Total Paid |
|---|---|---|
| 1 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $661K |
| 2 | 1083045140 | $232K |
| 3 | 1265462659 | $178K |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $101K |
| 5 | 1487622296 | $66K |
| 6 | 1467829309 | $42K |
| 7 | 1164671343 | $36K |
| 8 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $9K |
| 9 | St. Barnabas Hospital Bronx, NY · General Acute Care Hospital | $0 |
Showing top 9 of 9 providers billing this code