J7298
HCPCS Procedure Code
HCPCS code J7298 is the #799 most-billed Medicaid procedure code, with $77.8M in payments across 109K claims from 2018–2024. The national median cost per claim is $751.11.
Total Paid
$77.8M
0.01% of all spending
Total Claims
109K
Providers
306
Avg Cost/Claim
$711
National Cost Distribution
How much do providers bill per claim for J7298? Based on 282 providers billing this code nationally.
Median
$751.11
Average
$700.32
Std Dev
$325.25
Max
$2,968.77
Percentile Distribution (Cost per Claim)
50% of providers bill between $483.10 and $919.53 per claim for this code.
90% bill between $250.26 and $999.83.
Top 1% bill above $1,317.64.
About This Procedure
HCPCS code J7298 was billed by 306 providers across 109K claims, totaling $77.8M in Medicaid payments from 2018–2024. This code was used for 103K 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
$751.11
Providers Billing
282
National Spending
$77.8M
Avg/Median Ratio
0.93×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7298
| # | Provider | Total Paid |
|---|---|---|
| 1 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $10.8M |
| 2 | Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility | $7.3M |
| 3 | 1417938820 | $3.0M |
| 4 | 1013998921 | $2.8M |
| 5 | 1134100134 | $2.6M |
| 6 | 1518039858 | $2.2M |
| 7 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $1.7M |
| 8 | 1063486959 | $1.6M |
| 9 | 1518948413 | $1.6M |
| 10 | 1487749495 | $1.4M |
| 11 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $1.4M |
| 12 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $1.3M |
| 13 | 1760756860 | $1.2M |
| 14 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $1.2M |
| 15 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $1.2M |
| 16 | 1982798831 | $1.1M |
| 17 | 1043304769 | $1.0M |
| 18 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $1.0M |
| 19 | 1295270254 | $984K |
| 20 | 1184780355 | $891K |
Showing top 20 of 306 providers billing this code