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#297 of 11K

99395

Preventive medicine, established patient, age 18-39

Preventive medicine, established patient, age 18-39 is the #297 most-billed Medicaid procedure code, with $469.4M in payments across 7.5M claims from 2018–2024. The national median cost per claim is $72.71.

Total Paid

$469.4M

0.04% of all spending

Total Claims

7.5M

Providers

13K

Avg Cost/Claim

$63

National Cost Distribution

How much do providers bill per claim for 99395? Based on 11K providers billing this code nationally.

Median

$72.71

Average

$70.08

Std Dev

$40.29

Max

$493.76

Percentile Distribution (Cost per Claim)

p10
$10.33
p25
$47.26
Median
$72.71
p75
$90.67
p90
$114.97
p95
$128.07
p99
$187.05

50% of providers bill between $47.26 and $90.67 per claim for this code.

90% bill between $10.33 and $114.97.

Top 1% bill above $187.05.

About This Procedure

HCPCS code 99395 (Preventive medicine, established patient, age 18-39) was billed by 13K providers across 7.5M claims, totaling $469.4M in Medicaid payments from 2018–2024. This code was used for 6.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$72.71

Providers Billing

11K

National Spending

$469.4M

Avg/Median Ratio

0.96×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 99395

#ProviderTotal Paid
1The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$4.5M
2The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$3.7M
3Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$2.9M
4Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$2.6M
5Optum Medical Care Of New Jersey Pc

Secaucus, NJ · Durable Medical Equipment & Medical Supplies

$2.5M
6Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$2.4M
71053489260$2.2M
8Jamaica Hospital

Richmond Hill, NY · General Acute Care Hospital

$2.1M
9William Beaumont Hospital

Royal Oak, MI · Internal Medicine, Cardiovascular Disease

$1.9M
101003829441$1.8M
111154354744$1.8M
121477708469$1.8M
131801826680$1.7M
141417959701$1.7M
151205074739$1.6M
16Chinatown True Care Medical Pllc

New York, NY · Family Medicine

$1.6M
171144203498$1.6M
181760043723$1.5M
19Park Nicollet Clinic

St Louis Park, MN · Obstetrics & Gynecology

$1.5M
20Geisinger Clinic

Danville, PA · Surgery

$1.5M

Showing top 20 of 13K providers billing this code