HCPCS 90694

Drug (ClaimLight category; the code descriptor is not shown)

Drugs Drug code Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

34,250
99th percentile among 6,116 codes billed · 2020
$250M
99th percentile among 6,116 codes billed · 2020
4.3M
98th percentile among 6,116 codes billed · 2020
68
82nd percentile among 6,116 codes billed · 2020
329
77th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$200M$400M2020: $250M paid20202021: $257M paid20212022: $272M paid20222023: $365M paid20232024: $3.5M paid2024$3.5M$0$200M$400M2020: $250M paid20202021: $257M paid20212022: $272M paid20222023: $365M paid20232024: $3.5M paid2024$3.5M$0$200M$400M2020: $250M paid20202021: $257M paid20212022: $272M paid20222023: $365M paid20232024: $3.5M paid2024$3.5M$0$200M$400M2020: $250M paid20202021: $257M paid20212022: $272M paid20222023: $365M paid20232024: $3.5M paid2024$3.5M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

020K40K2020: 34K providers20202021: 45K providers20212022: 47K providers20222023: 52K providers20232024: 2,618 providers20242,618020K40K2020: 34K providers20202021: 45K providers20212022: 47K providers20222023: 52K providers20232024: 2,618 providers20242,618020K40K2020: 34K providers20202021: 45K providers20212022: 47K providers20222023: 52K providers20232024: 2,618 providers20242,618020K40K2020: 34K providers20202021: 45K providers20212022: 47K providers20222023: 52K providers20232024: 2,618 providers20242,618

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20242,618$3,516,119-99%47,08714280.00
202351,679$365,021,262+34%4,923,384503080.00
202247,284$271,589,451+6%3,966,496452570.00
202144,500$256,844,118+3%4,003,277512730.00
202034,250$249,786,099first year in data4,271,851683290.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida2,683$28,643,698478,98176707
Idaho103$23,634,668388,5309622,963
California3,282$19,243,822329,66066308
Pennsylvania2,269$12,088,800200,42869226
New York2,135$11,630,181195,58563264
Colorado414$10,283,601195,92954232
Texas2,091$10,116,788175,74759209
Ohio1,511$8,083,514136,33669240
Georgia1,075$7,828,792130,59859463
Virginia1,092$7,802,243131,35191314
Michigan1,153$6,669,667113,69482245
Massachusetts770$6,666,384112,529116382
North Carolina957$6,633,247111,99073382
South Carolina655$6,624,117110,52984732
Illinois1,137$6,347,510112,40776249

Not listed: 2 billers with an armed-forces or unknown state code (AE, ZZ); they are in the national totals.

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 2020.

Top metro areas

observed calculated calculated calculated calculated
Boise City, ID51$23,272,058381,88393
New York-Newark-Jersey City, NY-NJ1,992$12,188,723206,64072
Denver-Aurora-Centennial, CO190$9,209,736176,65244
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD901$5,804,48496,99388
Miami-Fort Lauderdale-West Palm Beach, FL641$5,189,59386,92960
Los Angeles-Long Beach-Anaheim, CA932$4,929,20984,16463
Atlanta-Sandy Springs-Roswell, GA641$4,740,47678,97759
Boston-Cambridge-Newton, MA-NH541$4,665,83978,844117
Washington-Arlington-Alexandria, DC-VA-MD-WV761$4,491,44875,45269
Chicago-Naperville-Elgin, IL-IN755$3,941,28871,04474
Tampa-St. Petersburg-Clearwater, FL412$3,463,57657,95569
North Port-Bradenton-Sarasota, FL131$2,855,39847,735192
San Francisco-Oakland-Fremont, CA495$2,774,49947,90169
Detroit-Warren-Dearborn, MI551$2,745,51346,70872
Baltimore-Columbia-Towson, MD397$2,690,92845,39879

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 2020.

Specialties billing 90694 nationally

Centralized Flu accounts for 45% of payment for 90694 nationally in 2020, across 24 specialties on claims.

observed calculated calculated calculated calculated calculated
Centralized Flu9,15627%$111,191,21145%1,976,825216
Mass Immunizer Roster Biller15,23444%$108,158,26643%1,773,797116
Internal Medicine3,0078.8%$10,894,2584.4%190,19663
Family Practice3,59110%$10,542,1464.2%180,20550
Pharmacy4721.4%$2,464,1450.99%40,41786
Nurse Practitioner1,3453.9%$2,346,9010.94%39,84730
Clinical Laboratory840.25%$1,262,5730.51%20,705246
Physician Assistant5251.5%$823,1580.33%14,14627
Pulmonary Disease1170.34%$223,6820.09%3,88033
Cardiology860.25%$215,6130.09%3,56942
General Practice530.15%$161,4570.06%2,67050
Rheumatology870.25%$156,4600.06%2,72431
Hematology-Oncology1060.31%$141,8120.06%2,39923
Geriatric Medicine410.12%$118,7320.05%2,03350
Allergy/ Immunology210.06%$109,0940.04%1,80286

Not listed: 27 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 2020.

Top billers of 90694 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