J3285
HCPCS Procedure Code
HCPCS code J3285 is the #673 most-billed Medicaid procedure code, with $107.8M in payments across 25K claims from 2018–2024. The national median cost per claim is $4,178.96.
Total Paid
$107.8M
0.01% of all spending
Total Claims
25K
Providers
9
Avg Cost/Claim
$4K
National Cost Distribution
How much do providers bill per claim for J3285? Based on 9 providers billing this code nationally.
Median
$4,178.96
Average
$4,382.97
Std Dev
$2,209.95
Max
$8,474.87
Percentile Distribution (Cost per Claim)
50% of providers bill between $3,169.29 and $5,661.47 per claim for this code.
90% bill between $1,822.86 and $6,972.89.
Top 1% bill above $8,324.67.
About This Procedure
HCPCS code J3285 was billed by 9 providers across 25K claims, totaling $107.8M in Medicaid payments from 2018–2024. This code was used for 14K 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
$4,178.96
Providers Billing
9
National Spending
$107.8M
Avg/Median Ratio
1.05×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J3285
| # | Provider | Total Paid |
|---|---|---|
| 1 | Accredo Health Group Inc Warrendale, PA · Pharmacy, Community/Retail Pharmacy | $55.3M |
| 2 | 1952359150 | $16.0M |
| 3 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $11.5M |
| 4 | 1013998921 | $8.9M |
| 5 | 1629029251 | $7.6M |
| 6 | Accredo Health Group Inc Memphis, TN · Pharmacy | $3.9M |
| 7 | 1134100134 | $3.5M |
| 8 | 1629232756 | $773K |
| 9 | Accredo Health Group Inc Orlando, FL · Pharmacy Specialty Pharmacy | $302K |
Showing top 9 of 9 providers billing this code