J7312
HCPCS Procedure Code
HCPCS code J7312 is the #4,602 most-billed Medicaid procedure code, with $494K in payments across 555 claims from 2018–2024. The national median cost per claim is $710.09. Costs vary widely — the 90th percentile is $1,445.79 per claim, 2.0× the median.
Total Paid
$494K
0.00% of all spending
Total Claims
555
Providers
6
Avg Cost/Claim
$891
National Cost Distribution
How much do providers bill per claim for J7312? Based on 5 providers billing this code nationally.
Median
$710.09
Average
$750.64
Std Dev
$661.28
Max
$1,695.45
Percentile Distribution (Cost per Claim)
50% of providers bill between $168.67 and $1,071.30 per claim for this code.
90% bill between $132.09 and $1,445.79.
Top 1% bill above $1,670.48.
About This Procedure
HCPCS code J7312 was billed by 6 providers across 555 claims, totaling $494K in Medicaid payments from 2018–2024. This code was used for 493 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
$710.09
Providers Billing
5
National Spending
$494K
Avg/Median Ratio
1.06×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7312
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $300K |
| 2 | 1114033404 | $133K |
| 3 | 1215003793 | $56K |
| 4 | University Of California Irvine Orange, CA · General Acute Care Hospital | $3K |
| 5 | 1962422709 | $3K |
| 6 | 1699986331 | $0 |
Showing top 6 of 6 providers billing this code