J7301
HCPCS Procedure Code
HCPCS code J7301 is the #2,705 most-billed Medicaid procedure code, with $4.0M in payments across 5,697 claims from 2018–2024. The national median cost per claim is $738.11.
Total Paid
$4.0M
0.00% of all spending
Total Claims
5,697
Providers
18
Avg Cost/Claim
$710
National Cost Distribution
How much do providers bill per claim for J7301? Based on 18 providers billing this code nationally.
Median
$738.11
Average
$692.01
Std Dev
$226.32
Max
$1,154.72
Percentile Distribution (Cost per Claim)
50% of providers bill between $709.72 and $753.71 per claim for this code.
90% bill between $478.36 and $814.95.
Top 1% bill above $1,104.60.
About This Procedure
HCPCS code J7301 was billed by 18 providers across 5,697 claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 4,868 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
$738.11
Providers Billing
18
National Spending
$4.0M
Avg/Median Ratio
0.94×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7301
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1720217698 | $1.2M |
| 2 | 1073647327 | $664K |
| 3 | 1134291032 | $577K |
| 4 | 1720129141 | $398K |
| 5 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $374K |
| 6 | 1417959701 | $316K |
| 7 | 1487749495 | $211K |
| 8 | 1336174325 | $166K |
| 9 | 1689978850 | $50K |
| 10 | 1699860999 | $36K |
| 11 | 1912176264 | $27K |
| 12 | 1053420992 | $19K |
| 13 | 1982798831 | $14K |
| 14 | 1396714184 | $11K |
| 15 | 1467411744 | $9K |
| 16 | 1780674622 | $9K |
| 17 | 1992152748 | $8K |
| 18 | 1235399379 | $2K |
Showing top 18 of 18 providers billing this code