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#7124 of 11K

J7342

HCPCS Procedure Code

HCPCS code J7342 is the #7,124 most-billed Medicaid procedure code, with $27K in payments across 2K claims from 2018–2024. The national median cost per claim is $12.71.

Total Paid

$27K

0.00% of all spending

Total Claims

2K

Providers

9

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for J7342? Based on 6 providers billing this code nationally.

Median

$12.71

Average

$12.77

Std Dev

$10.93

Max

$26.30

Percentile Distribution (Cost per Claim)

p10
$2.09
p25
$3.84
Median
$12.71
p75
$20.67
p90
$23.53
p95
$24.91
p99
$26.02

50% of providers bill between $3.84 and $20.67 per claim for this code.

90% bill between $2.09 and $23.53.

Top 1% bill above $26.02.

About This Procedure

HCPCS code J7342 was billed by 9 providers across 2K claims, totaling $27K in Medicaid payments from 2018–2024. This code was used for 2K 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

$12.71

Providers Billing

6

National Spending

$27K

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7342

#ProviderTotal Paid
1Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$19K
2Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$5K
31952643306$2K
4Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$1K
51093714073$260
61154419737$28
71093719932$0
81336103738$0
91588631311$0

Showing top 9 of 9 providers billing this code