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#3302 of 11K

91300

COVID-19 vaccine (Pfizer), first dose

COVID-19 vaccine (Pfizer), first dose is the #3,302 most-billed Medicaid procedure code, with $2.0M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $2.67 per claim, 267.0× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

3.4M

Providers

6K

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for 91300? Based on 1K providers billing this code nationally.

Median

$0.01

Average

$4.46

Std Dev

$33.97

Max

$510.95

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.09
p90
$2.67
p95
$9.29
p99
$130.55

50% of providers bill between $0.00 and $0.09 per claim for this code.

90% bill between $0.00 and $2.67.

Top 1% bill above $130.55.

About This Procedure

HCPCS code 91300 (COVID-19 vaccine (Pfizer), first dose) was billed by 6K providers across 3.4M claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 2.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

1K

National Spending

$2.0M

Avg/Median Ratio

446.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 91300

#ProviderTotal Paid
1Utah Navajo Health System, Incorporated

Montezuma Creek, UT · Family Medicine

$769K
21336245828$103K
3Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$87K
4Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$84K
51740357169$66K
6Central Oklahoma American Indian Health Council Inc.

Oklahoma City, OK · Clinic/Center Federally Qualified Health Center (FQHC)

$63K
71700062296$61K
8Alamo Navajo School Board, Inc.

Alamo, NM · Clinic/Center, Primary Care

$56K
91548267420$52K
101669485975$50K
111376104125$39K
121801835970$34K
13Lexington Health Inc

West Columbia, SC · General Acute Care Hospital

$24K
141285646455$24K
151871505032$21K
161144302415$20K
171205902376$19K
181922024835$19K
19Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$18K
201275196222$17K

Showing top 20 of 6K providers billing this code