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#79 of 11K

99391

Preventive medicine, established patient, infant (under 1)

Preventive medicine, established patient, infant (under 1) is the #79 most-billed Medicaid procedure code, with $2.47B in payments across 37.1M claims from 2018–2024. The national median cost per claim is $69.35.

Total Paid

$2.47B

0.23% of all spending

Total Claims

37.1M

Providers

18K

Avg Cost/Claim

$67

National Cost Distribution

How much do providers bill per claim for 99391? Based on 17K providers billing this code nationally.

Median

$69.35

Average

$69.13

Std Dev

$38.27

Max

$806.26

Percentile Distribution (Cost per Claim)

p10
$23.58
p25
$52.21
Median
$69.35
p75
$84.26
p90
$99.51
p95
$119.26
p99
$197.91

50% of providers bill between $52.21 and $84.26 per claim for this code.

90% bill between $23.58 and $99.51.

Top 1% bill above $197.91.

About This Procedure

HCPCS code 99391 (Preventive medicine, established patient, infant (under 1)) was billed by 18K providers across 37.1M claims, totaling $2.47B in Medicaid payments from 2018–2024. This code was used for 33.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$69.35

Providers Billing

17K

National Spending

$2.47B

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99391

#ProviderTotal Paid
1Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$28.9M
2Saltzman Tanis Pittell Levin And Jacobson

Hollywood, FL · Pediatrics

$25.8M
3Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$23.6M
4Topcare Medical Group Inc

Dallas, TX · Pediatrics

$9.9M
5Legacy Community Health Services, Inc

Houston, TX · Pediatrics

$9.1M
6Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$8.6M
7Presbyterian Healthcare Services

Albuquerque, NM · Surgery

$7.2M
8The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$7.0M
9Community Physicians Of Indiana Inc

Indianapolis, IN · Internal Medicine

$6.9M
10The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$6.8M
11Utmb Faculty Group Practice

Galveston, TX · Anesthesiology

$6.8M
121326695255$6.7M
13Cook Children's Physician Network

Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)

$6.5M
141346249430$6.5M
15Baltimore Medical System Inc

Baltimore, MD · Clinic/Center Federally Qualified Health Center (FQHC)

$6.3M
16The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$6.2M
17Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$5.4M
18Prisma Health University Medical Group

Greenville, SC · Internal Medicine

$5.4M
191144268277$5.2M
201184016941$5.1M

Showing top 20 of 18K providers billing this code