HCPCS 0004A
Other service (ClaimLight category; the code descriptor is not shown)
Other services
Trend
Medicare payment on the code
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.
Billers
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.
| observed | calculated | calculated | calculated | calculated | calculated | reported | |
|---|---|---|---|---|---|---|---|
| 2023 | 27 | $53,886 | -100% | 1,254 | 15 | 193 | 0.00 |
| 2022 | 11,002 | $19,203,903 | -93% | 484,191 | 19 | 115 | |
| 2021 | 33,439 | $285,625,410 | not in the 2020 file | 7,051,914 | 100 | 590 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2021–2023.
By state
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| California | 2,475 | $31,610,579 | 708,731 | 127 | 684 | |
| Florida | 2,755 | $24,610,254 | 623,016 | 173 | 580 | |
| Idaho | 139 | $17,185,679 | 411,822 | 87 | 14,315 | |
| New York | 1,700 | $16,432,840 | 378,989 | 113 | 816 | |
| Pennsylvania | 1,729 | $14,954,439 | 375,678 | 117 | 619 | |
| Texas | 2,368 | $14,381,781 | 361,122 | 100 | 391 | |
| Colorado | 775 | $14,142,099 | 349,031 | 47 | 295 | |
| Ohio | 1,497 | $11,428,989 | 300,952 | 126 | 622 | |
| Illinois | 1,160 | $9,174,927 | 226,113 | 122 | 548 | |
| Massachusetts | 550 | $9,064,608 | 202,456 | 156 | 1,334 | |
| New Jersey | 763 | $8,288,028 | 186,433 | 139 | 737 | |
| North Carolina | 1,139 | $7,556,487 | 198,166 | 103 | 557 | |
| Minnesota | 1,170 | $7,103,834 | 177,760 | 36 | 471 | |
| Virginia | 951 | $6,339,869 | 154,503 | 82 | 571 | |
| Michigan | 1,012 | $6,054,893 | 155,147 | 84 | 525 |
Not listed: 3 states with fewer than 11 billers (small cells).
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2021.
Top metro areas
| observed | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|
| Boise City, ID | 80 | $16,819,894 | 401,765 | 78 | |
| New York-Newark-Jersey City, NY-NJ | 1,411 | $15,140,117 | 330,190 | 109 | |
| Denver-Aurora-Centennial, CO | 488 | $12,937,419 | 319,399 | 42 | |
| Los Angeles-Long Beach-Anaheim, CA | 825 | $11,057,552 | 247,739 | 130 | |
| San Francisco-Oakland-Fremont, CA | 285 | $7,873,747 | 166,737 | 161 | |
| Miami-Fort Lauderdale-West Palm Beach, FL | 749 | $7,457,937 | 183,613 | 200 | |
| Philadelphia-Camden-Wilmington, PA-NJ-DE-MD | 735 | $6,954,220 | 163,305 | 131 | |
| Chicago-Naperville-Elgin, IL-IN | 735 | $6,169,027 | 150,301 | 139 | |
| Boston-Cambridge-Newton, MA-NH | 391 | $5,984,626 | 135,352 | 157 | |
| Minneapolis-St. Paul-Bloomington, MN-WI | 791 | $5,247,790 | 131,363 | 36 | |
| Tampa-St. Petersburg-Clearwater, FL | 428 | $4,494,336 | 115,618 | 224 | |
| Washington-Arlington-Alexandria, DC-VA-MD-WV | 805 | $4,439,116 | 99,142 | 64 | |
| Dallas-Fort Worth-Arlington, TX | 606 | $4,131,961 | 103,315 | 129 | |
| Houston-Pasadena-The Woodlands, TX | 634 | $3,881,530 | 96,116 | 91 | |
| Atlanta-Sandy Springs-Roswell, GA | 543 | $3,840,685 | 97,276 | 141 |
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 100 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.
Specialties billing 0004A nationally
Mass Immunizer Roster Biller accounts for 55% of payment for 0004A nationally in 2021, across 17 specialties on claims.
| observed | calculated | calculated | calculated | calculated | calculated | |
|---|---|---|---|---|---|---|
| Mass Immunizer Roster Biller | 17,338 | 52% | $155,679,601 | 55% | 3,853,157 | 222 |
| Centralized Flu | 7,158 | 21% | $88,929,061 | 31% | 2,195,712 | 307 |
| Family Practice | 3,685 | 11% | $10,259,005 | 3.6% | 258,851 | 70 |
| Internal Medicine | 1,987 | 5.9% | $9,099,803 | 3.2% | 221,839 | 112 |
| Infectious Disease | 23 | 0.07% | $5,769,225 | 2.0% | 129,659 | 5,637 |
| Pharmacy | 731 | 2.2% | $3,597,876 | 1.3% | 89,962 | 123 |
| Nurse Practitioner | 1,532 | 4.6% | $3,003,950 | 1.1% | 79,262 | 52 |
| Pediatric Medicine | 84 | 0.25% | $2,951,647 | 1.0% | 69,576 | 828 |
| Clinical Laboratory | 201 | 0.60% | $1,149,952 | 0.40% | 29,567 | 147 |
| Hospitalist | 19 | 0.06% | $1,031,973 | 0.36% | 23,591 | 1,242 |
| Emergency Medicine | 69 | 0.21% | $546,590 | 0.19% | 13,580 | 197 |
| Physician Assistant | 346 | 1.0% | $489,364 | 0.17% | 13,094 | 38 |
| Obstetrics & Gynecology | 14 | 0.04% | $317,091 | 0.11% | 7,120 | 509 |
| Public Health or Welfare Agency | 36 | 0.11% | $229,321 | 0.08% | 5,871 | 163 |
| General Practice | 48 | 0.14% | $156,588 | 0.05% | 3,912 | 82 |
Not listed: 36 specialties with fewer than 11 billers (small cells).
Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2021.
Top billers of 0004A nationally
Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.
Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations