HCPCS 91320

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

Drugs Drug code

27,083
99th percentile among 6,405 codes billed · 2023
$422M
99th percentile among 6,405 codes billed · 2023
3.3M
98th percentile among 6,405 codes billed · 2023
60
78th percentile among 6,405 codes billed · 2023
356
76th percentile among 6,405 codes billed · 2023

Trend

Medicare payment on the code

$0$250M$500M2023: $422M paid20232024: $664M paid2024$664M$0$250M$500M2023: $422M paid20232024: $664M paid2024$664M$0$250M$500M2023: $422M paid20232024: $664M paid2024$664M$0$250M$500M2023: $422M paid20232024: $664M paid2024$664M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2023–2024.

Billers

020K40K2023: 27K providers20232024: 37K providers202437K020K40K2023: 27K providers20232024: 37K providers202437K020K40K2023: 27K providers20232024: 37K providers202437K020K40K2023: 27K providers20232024: 37K providers202437K

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2023–2024.

observed calculated calculated calculated calculated calculated reported
202436,800$663,520,364+57%4,506,697593670.00
202327,083$422,068,649not in the 2022 file3,323,18360356

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2023–2024.

By state

observed calculated calculated calculated calculated calculated
California2,328$37,584,070295,00078397
Idaho139$32,193,064250,864585,528
Colorado628$26,453,328212,62739239
Florida1,444$22,449,061177,49174329
New York1,192$21,478,751168,75074482
Pennsylvania1,785$19,936,695155,79049292
Texas1,752$17,272,519135,95257195
Illinois942$16,243,734128,69992398
Massachusetts643$16,127,051126,43882693
Ohio1,254$15,290,785120,23067258
Virginia907$13,596,837106,69070363
New Jersey778$12,858,975100,93673412
North Carolina902$11,089,37387,33362295
Maryland662$9,960,84777,92758428
Iowa458$9,179,16871,86086501

Not listed: 1 billers with an armed-forces or unknown state code (AE); 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 2023.

Top metro areas

observed calculated calculated calculated calculated
Boise City, ID72$31,168,850242,68459
New York-Newark-Jersey City, NY-NJ1,272$24,674,321193,79181
Denver-Aurora-Centennial, CO284$23,350,167188,14039
Chicago-Naperville-Elgin, IL-IN607$11,999,71395,369111
Boston-Cambridge-Newton, MA-NH530$11,336,96788,89150
Los Angeles-Long Beach-Anaheim, CA809$10,593,20383,10469
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD638$10,016,37478,42074
Washington-Arlington-Alexandria, DC-VA-MD-WV574$8,099,60763,30259
San Francisco-Oakland-Fremont, CA276$6,708,76752,738144
Baltimore-Columbia-Towson, MD358$5,217,00840,88056
Minneapolis-St. Paul-Bloomington, MN-WI520$5,118,23740,68526
Seattle-Tacoma-Bellevue, WA354$4,772,17837,35370
Miami-Fort Lauderdale-West Palm Beach, FL347$4,657,80837,06458
St. Louis, MO-IL223$4,491,66635,673138
Phoenix-Mesa-Chandler, AZ296$4,484,60035,34460

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 91320 nationally

Mass Immunizer Roster Biller accounts for 51% of payment for 91320 nationally in 2023, across 18 specialties on claims.

observed calculated calculated calculated calculated calculated
Mass Immunizer Roster Biller13,81951%$215,545,61451%1,678,822121
Centralized Flu5,79821%$164,917,60939%1,317,259227
Pharmacy1,1104.1%$12,588,6173.0%98,26289
Family Practice2,6229.7%$10,455,5562.5%82,79532
Internal Medicine1,9527.2%$10,256,0512.4%80,72241
Nurse Practitioner1,1084.1%$3,256,1950.77%25,49823
Public Health or Welfare Agency660.24%$1,338,3510.32%10,614161
Clinical Laboratory720.27%$777,3860.18%6,05484
Physician Assistant2630.97%$643,2430.15%5,06519
Infectious Disease200.07%$495,9170.12%3,872194
Hospitalist190.07%$232,6560.06%1,81596
All Other Suppliers190.07%$227,6670.05%1,77293
Pediatric Medicine370.14%$189,7590.04%1,51541
Geriatric Medicine360.13%$178,4860.04%1,40139
General Practice280.10%$149,6800.04%1,21443

Not listed: 22 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 91320 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