99381
Preventive visit, new patient, infant (<1 yr)
Preventive visit, new patient, infant (<1 yr) is the #665 most-billed Medicaid procedure code, with $111.3M in payments across 1.7M claims from 2018–2024. The national median cost per claim is $73.46.
Total Paid
$111.3M
0.01% of all spending
Total Claims
1.7M
Providers
4K
Avg Cost/Claim
$67
National Cost Distribution
How much do providers bill per claim for 99381? Based on 4K providers billing this code nationally.
Median
$73.46
Average
$73.31
Std Dev
$42.91
Max
$854.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $52.80 and $89.77 per claim for this code.
90% bill between $20.02 and $109.32.
Top 1% bill above $218.16.
About This Procedure
HCPCS code 99381 (Preventive visit, new patient, infant (<1 yr)) was billed by 4K providers across 1.7M claims, totaling $111.3M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$73.46
Providers Billing
4K
National Spending
$111.3M
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99381
| # | Provider | Total Paid |
|---|---|---|
| 1 | Legacy Community Health Services, Inc Houston, TX · Pediatrics | $6.4M |
| 2 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $1.6M |
| 3 | Utmb Faculty Group Practice Galveston, TX · Anesthesiology | $1.3M |
| 4 | El Centro Del Barrio, Inc. San Antonio, TX · Clinic/Center, Federally Qualified Health Center (FQHC) | $1.3M |
| 5 | Barrio Comprehensive Family Health Care Center, Inc. San Antonio, TX · Clinic/Center, Multi-Specialty | $1.2M |
| 6 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $1.1M |
| 7 | Topcare Medical Group Inc Dallas, TX · Pediatrics | $1.1M |
| 8 | 1568726214 | $977K |
| 9 | 1558452730 | $906K |
| 10 | 1356428460 | $889K |
| 11 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $704K |
| 12 | 1720350978 | $690K |
| 13 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $682K |
| 14 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $571K |
| 15 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $561K |
| 16 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $547K |
| 17 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $484K |
| 18 | 1144575820 | $477K |
| 19 | 1861420382 | $475K |
| 20 | Lynn Community Health, Inc. Lynn, MA · Clinic/Center, Community Health | $465K |
Showing top 20 of 4K providers billing this code