J2357
Injection, omalizumab, 5 mg
Injection, omalizumab, 5 mg is the #457 most-billed Medicaid procedure code, with $211.9M in payments across 201K claims from 2018–2024. The national median cost per claim is $920.37. Costs vary widely — the 90th percentile is $2,240.20 per claim, 2.4× the median.
Total Paid
$211.9M
0.02% of all spending
Total Claims
201K
Providers
213
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for J2357? Based on 196 providers billing this code nationally.
Median
$920.37
Average
$1,044.79
Std Dev
$908.44
Max
$4,579.08
Percentile Distribution (Cost per Claim)
50% of providers bill between $238.58 and $1,593.04 per claim for this code.
90% bill between $0.01 and $2,240.20.
Top 1% bill above $3,532.93.
About This Procedure
HCPCS code J2357 (Injection, omalizumab, 5 mg) was billed by 213 providers across 201K claims, totaling $211.9M in Medicaid payments from 2018–2024. This code was used for 125K 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
$920.37
Providers Billing
196
National Spending
$211.9M
Avg/Median Ratio
1.14×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2357
| # | Provider | Total Paid |
|---|---|---|
| 1 | Accredo Health Group Inc Memphis, TN · Pharmacy | $20.7M |
| 2 | 1265462659 | $12.1M |
| 3 | 1710057500 | $12.0M |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $10.6M |
| 5 | 1174693592 | $10.1M |
| 6 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $10.0M |
| 7 | 1134100134 | $6.8M |
| 8 | 1871526459 | $6.5M |
| 9 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $6.2M |
| 10 | 1538281837 | $5.6M |
| 11 | 1598875460 | $5.4M |
| 12 | 1083045140 | $5.0M |
| 13 | 1023175239 | $4.2M |
| 14 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $3.6M |
| 15 | 1720364532 | $3.3M |
| 16 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $3.3M |
| 17 | 1417097593 | $3.0M |
| 18 | Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children | $3.0M |
| 19 | Holyoke Medical Center, Inc. Holyoke, MA · Clinic/Center, Adult Mental Health | $2.6M |
| 20 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $2.5M |
Showing top 20 of 213 providers billing this code