HCPCS 90694

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

Drugs Drug code Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

51,679
100th percentile among 6,405 codes billed · 2023
$365M
99th percentile among 6,405 codes billed · 2023
4.9M
98th percentile among 6,405 codes billed · 2023
50
74th percentile among 6,405 codes billed · 2023
308
74th percentile among 6,405 codes billed · 2023
+34.4%
Medicare payment on the code vs 2022; billers +9.3% · 2023

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
California5,017$38,590,565521,68549361
Florida3,464$33,566,460450,45172422
New York3,121$22,308,429302,91255333
Pennsylvania2,403$18,095,636241,12469300
Texas3,140$16,119,605217,32943210
Massachusetts1,532$13,216,250178,89449397
Ohio2,283$13,215,680176,41750228
North Carolina2,250$12,823,118171,06643247
New Jersey1,456$12,237,405166,32370345
Virginia1,482$11,933,350159,86567326
Illinois1,827$11,842,676160,57656250
Colorado702$10,363,618145,20631183
South Carolina1,051$9,934,508132,37867436
Maryland1,289$9,901,977133,45561352
Michigan1,564$9,084,960121,94053224

Not listed: 3 billers with an armed-forces or unknown state code (AE, ZZ); they are in the national totals.

Not listed: 2 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ3,009$24,751,085337,58062
Los Angeles-Long Beach-Anaheim, CA1,542$11,128,937151,04148
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD1,100$9,439,348126,68480
Boston-Cambridge-Newton, MA-NH1,054$9,111,131123,71048
Denver-Aurora-Centennial, CO338$8,764,901123,46331
Chicago-Naperville-Elgin, IL-IN1,262$7,724,842105,19253
Washington-Arlington-Alexandria, DC-VA-MD-WV1,080$7,334,71499,14454
Miami-Fort Lauderdale-West Palm Beach, FL862$6,994,85894,16351
San Francisco-Oakland-Fremont, CA663$5,729,57777,91745
Baltimore-Columbia-Towson, MD705$5,134,27069,15855
Atlanta-Sandy Springs-Roswell, GA741$4,889,55965,36655
Seattle-Tacoma-Bellevue, WA838$4,714,50662,83829
Dallas-Fort Worth-Arlington, TX896$4,600,48761,85238
Orlando-Kissimmee-Sanford, FL416$4,027,03453,90767
Detroit-Warren-Dearborn, MI676$4,017,21654,05058

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 2023.

Specialties billing 90694 nationally

Mass Immunizer Roster Biller accounts for 54% of payment for 90694 nationally in 2023, across 29 specialties on claims.

observed calculated calculated calculated calculated calculated
Mass Immunizer Roster Biller17,28033%$195,840,16354%2,623,369152
Centralized Flu8,75317%$80,184,82522%1,097,116125
Family Practice9,05318%$28,652,6057.8%387,30643
Internal Medicine6,99714%$28,321,1867.8%384,78255
Pharmacy1,6103.1%$13,225,0473.6%175,472109
Nurse Practitioner4,8269.3%$9,105,9972.5%124,95626
Physician Assistant1,4472.8%$2,637,5570.72%35,77125
Pediatric Medicine860.17%$1,186,6630.33%15,842184
Clinical Laboratory1120.22%$928,4640.25%12,300110
Pulmonary Disease2450.47%$551,2040.15%7,47931
Public Health or Welfare Agency160.03%$419,2900.11%5,603350
Rheumatology2010.39%$400,0610.11%5,45527
Cardiology1210.23%$386,8230.11%5,15843
General Practice1050.20%$364,9050.10%4,94447
Geriatric Medicine1070.21%$332,9040.09%4,45742

Not listed: 28 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 2023.

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