Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5796 of 11K

J7351

HCPCS Procedure Code

HCPCS code J7351 is the #5,796 most-billed Medicaid procedure code, with $136K in payments across 414 claims from 2018–2024. The national median cost per claim is $386.60.

Total Paid

$136K

0.00% of all spending

Total Claims

414

Providers

3

Avg Cost/Claim

$329

National Cost Distribution

How much do providers bill per claim for J7351? Based on 2 providers billing this code nationally.

Median

$386.60

Average

$386.60

Std Dev

$168.07

Max

$505.44

Percentile Distribution (Cost per Claim)

p10
$291.52
p25
$327.18
Median
$386.60
p75
$446.02
p90
$481.67
p95
$493.56
p99
$503.06

50% of providers bill between $327.18 and $446.02 per claim for this code.

90% bill between $291.52 and $481.67.

Top 1% bill above $503.06.

About This Procedure

HCPCS code J7351 was billed by 3 providers across 414 claims, totaling $136K in Medicaid payments from 2018–2024. This code was used for 261 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

$386.60

Providers Billing

2

National Spending

$136K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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