99394
Preventive medicine, established patient, age 12-17
Preventive medicine, established patient, age 12-17 is the #148 most-billed Medicaid procedure code, with $1.24B in payments across 19.0M claims from 2018–2024. The national median cost per claim is $80.15.
Total Paid
$1.24B
0.11% of all spending
Total Claims
19.0M
Providers
20K
Avg Cost/Claim
$65
National Cost Distribution
How much do providers bill per claim for 99394? Based on 18K providers billing this code nationally.
Median
$80.15
Average
$76.67
Std Dev
$47.27
Max
$741.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $55.34 and $94.70 per claim for this code.
90% bill between $14.08 and $113.90.
Top 1% bill above $218.17.
About This Procedure
HCPCS code 99394 (Preventive medicine, established patient, age 12-17) was billed by 20K providers across 19.0M claims, totaling $1.24B in Medicaid payments from 2018–2024. This code was used for 17.4M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$80.15
Providers Billing
18K
National Spending
$1.24B
Avg/Median Ratio
0.96×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 99394
| # | Provider | Total Paid |
|---|---|---|
| 1 | Saltzman Tanis Pittell Levin And Jacobson Hollywood, FL · Pediatrics | $12.1M |
| 2 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $11.2M |
| 3 | Topcare Medical Group Inc Dallas, TX · Pediatrics | $10.9M |
| 4 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $7.4M |
| 5 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $4.1M |
| 6 | Optum Medical Care Of New Jersey Pc Secaucus, NJ · Durable Medical Equipment & Medical Supplies | $3.6M |
| 7 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $3.5M |
| 8 | 1730337163 | $3.4M |
| 9 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $3.4M |
| 10 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $3.4M |
| 11 | Montefiore Medical Center Bronx, NY · Anesthesiology | $3.3M |
| 12 | 1346249430 | $3.2M |
| 13 | El Centro Del Barrio, Inc. San Antonio, TX · Clinic/Center, Federally Qualified Health Center (FQHC) | $3.1M |
| 14 | Baltimore Medical System Inc Baltimore, MD · Clinic/Center Federally Qualified Health Center (FQHC) | $3.0M |
| 15 | 1821288606 | $2.9M |
| 16 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $2.7M |
| 17 | 1265499628 | $2.7M |
| 18 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $2.6M |
| 19 | 1790839405 | $2.6M |
| 20 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $2.4M |
Showing top 20 of 20K providers billing this code