90472
Immunization administration, each additional vaccine
Immunization administration, each additional vaccine is the #400 most-billed Medicaid procedure code, with $269.0M in payments across 20.8M claims from 2018–2024. The national median cost per claim is $11.79. Costs vary widely — the 90th percentile is $28.91 per claim, 2.5× the median.
Total Paid
$269.0M
0.02% of all spending
Total Claims
20.8M
Providers
11K
Avg Cost/Claim
$13
National Cost Distribution
How much do providers bill per claim for 90472? Based on 9K providers billing this code nationally.
Median
$11.79
Average
$13.40
Std Dev
$11.74
Max
$212.55
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.46 and $18.89 per claim for this code.
90% bill between $0.56 and $28.91.
Top 1% bill above $45.43.
About This Procedure
HCPCS code 90472 (Immunization administration, each additional vaccine) was billed by 11K providers across 20.8M claims, totaling $269.0M in Medicaid payments from 2018–2024. This code was used for 18.0M unique beneficiaries.
Risk Assessment
This procedure is featured in our investigation: COVID Vaccine Drive
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$11.79
Providers Billing
9K
National Spending
$269.0M
Avg/Median Ratio
1.14×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 90472
| # | Provider | Total Paid |
|---|---|---|
| 1 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $4.7M |
| 2 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $2.5M |
| 3 | Wake Forest University Health Sciences Winston Salem, NC · Clinic/Center, Multi-Specialty | $2.1M |
| 4 | 1598729014 | $2.0M |
| 5 | Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine | $2.0M |
| 6 | 1114044369 | $1.9M |
| 7 | Our Lady Of The Lake Physician Group Llc Baton Rouge, LA · Allergy & Immunology | $1.9M |
| 8 | 1326110909 | $1.8M |
| 9 | Bexar County Hospital District San Antonio, TX · Clinical Medical Laboratory | $1.8M |
| 10 | 1164519070 | $1.6M |
| 11 | 1427018894 | $1.5M |
| 12 | 1710945969 | $1.5M |
| 13 | 1134163942 | $1.4M |
| 14 | 1427125269 | $1.4M |
| 15 | 1932130952 | $1.4M |
| 16 | 1144513375 | $1.4M |
| 17 | 1093800534 | $1.3M |
| 18 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $1.3M |
| 19 | 1225327984 | $1.2M |
| 20 | 1336564863 | $1.2M |
Showing top 20 of 11K providers billing this code