HCPCS 90694

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

Drugs Drug code Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

44,500
99th percentile among 6,253 codes billed · 2021
$257M
99th percentile among 6,253 codes billed · 2021
4.0M
98th percentile among 6,253 codes billed · 2021
51
75th percentile among 6,253 codes billed · 2021
273
74th percentile among 6,253 codes billed · 2021
+2.8%
Medicare payment on the code vs 2020; billers +29.9% · 2021

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
Florida3,156$25,282,454389,65467418
California3,858$20,087,014310,90950251
New York2,705$15,635,290239,95653274
Pennsylvania2,337$13,965,427212,22466243
Colorado603$9,731,316166,33537177
Texas2,552$9,616,230150,30738174
Massachusetts1,037$9,358,842143,03982409
Ohio2,015$9,135,523140,48048198
Virginia1,418$9,070,949139,51966288
North Carolina1,655$8,663,546133,04949254
New Jersey1,250$8,647,600133,18373307
Michigan1,574$7,517,204116,78452211
Maryland1,094$7,067,134107,95460298
Georgia1,307$7,021,602107,48844270
Illinois1,248$6,999,228111,75562249

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ2,557$17,350,525266,95064
Denver-Aurora-Centennial, CO279$8,319,902144,09832
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD981$6,599,616100,80878
Boston-Cambridge-Newton, MA-NH741$6,298,28796,41782
Washington-Arlington-Alexandria, DC-VA-MD-WV962$5,396,41682,31452
Los Angeles-Long Beach-Anaheim, CA1,172$5,328,81282,01446
Miami-Fort Lauderdale-West Palm Beach, FL685$4,454,95068,57549
Chicago-Naperville-Elgin, IL-IN834$4,402,90370,98463
Atlanta-Sandy Springs-Roswell, GA708$4,054,62162,04249
Baltimore-Columbia-Towson, MD534$3,375,13951,73259
Seattle-Tacoma-Bellevue, WA564$3,092,68248,20437
Tampa-St. Petersburg-Clearwater, FL468$2,959,82645,66465
Detroit-Warren-Dearborn, MI642$2,902,31445,08352
Kansas City, MO-KS586$2,745,52141,95138
San Francisco-Oakland-Fremont, CA520$2,667,12541,90949

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 90694 nationally

Mass Immunizer Roster Biller accounts for 49% of payment for 90694 nationally in 2021, across 28 specialties on claims.

observed calculated calculated calculated calculated calculated
Mass Immunizer Roster Biller17,13539%$125,640,00749%1,895,270111
Centralized Flu8,56819%$69,901,62627%1,155,816135
Internal Medicine5,53312%$21,551,2568.4%337,35061
Family Practice6,48215%$20,467,9558.0%317,93649
Pharmacy1,2872.9%$7,093,1702.8%106,96983
Nurse Practitioner2,6025.8%$4,697,4321.8%72,41228
Physician Assistant9702.2%$1,681,7990.65%26,16827
Clinical Laboratory2320.52%$1,349,3330.53%21,86294
Pulmonary Disease2370.53%$473,6300.18%7,39231
Cardiology1500.34%$470,5460.18%7,16948
Rheumatology1940.44%$385,4670.15%6,02631
General Practice920.21%$370,3050.14%5,64361
Hematology-Oncology2230.50%$338,6050.13%5,19623
Public Health or Welfare Agency150.03%$300,6300.12%4,581305
Endocrinology1380.31%$266,4950.10%4,11930

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 2021.

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