Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

Billing Codes in Arizona

All 4,357 procedure codes billed by Medicaid providers in Arizona, ranked by total spending.

#CodeDescriptionTotal Paid
1 S5125 Attendant care services; per 15 minutes $3.47B
2 T1015 Clinic visit/encounter, all-inclusive $2.77B
3 T2016 Habilitation, residential, waiver; per diem $1.42B
4 T1016 Case management, each 15 minutes $1.39B
5 H0004 Behavioral health counseling and therapy, per 15 minutes $1.19B
6 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $1.05B
7 99285 Emergency department visit for the evaluation and management, high severity with immediate threat to life $904.14M
8 99284 Emergency department visit for the evaluation and management, high severity $873.66M
9 H0018 Behavioral health; short-term residential (non-hospital residential treatment program), without room and board, per diem $816.04M
10 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $740.87M
11 T2033 Residential care, not otherwise specified (nos), waiver; per diem $721.93M
12 H2014 Skills training and development, per 15 minutes $680.03M
13 99283 Emergency department visit for the evaluation and management, moderate severity $664.30M
14 H0015 Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including assessment, counseling; crisis intervention, and activity therapies or education $635.52M
15 S0215 Non-emergency transportation; mileage, per mile $603.05M
16 T2017 Habilitation, residential, waiver; 15 minutes $566.10M
17 S5150 Unskilled respite care, not hospice; per 15 minutes $548.43M
18 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $543.14M
19 74177 Computed tomography, abdomen and pelvis; with contrast material $386.69M
20 A0429 Ambulance service, basic life support, emergency transport (bls-emergency) $381.74M
21 A0425 Ground mileage, per statute mile $326.55M
22 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $318.59M
23 H2027 Psychoeducational service, per 15 minutes $294.96M
24 H0031 Mental health assessment, by non-physician $293.73M
25 90999 Unlisted dialysis procedure, inpatient or outpatient $281.97M
26 H0038 Self-help/peer services, per 15 minutes $279.68M
27 H2016 Comprehensive community support services, per diem $263.01M
28 H2017 Psychosocial rehabilitation services, per 15 minutes $261.75M
29 S9124 Nursing care, in the home; by licensed practical nurse, per hour $257.62M
30 T2021 Day habilitation, waiver; per 15 minutes $252.69M
31 99233 Prolong inpt eval add15 m $246.20M
32 97530 Therapeutic activities, direct patient contact, each 15 minutes $232.43M
33 97535 Self-care/home management training, each 15 minutes $220.12M
34 U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r $187.20M
35 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $159.18M
36 99232 Subsequent hospital care, per day, moderate complexity $157.73M
37 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $147.59M
38 A0428 Ambulance service, basic life support, non-emergency transport, (bls) $144.82M
39 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $137.38M
40 A0120 Non-emergency transportation: mini-bus, mountain area transports, or other transportation systems $136.27M
41 S9480 Intensive outpatient psychiatric services, per diem $133.34M
42 H2010 Comprehensive medication services, per 15 minutes $129.73M
43 S9123 Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) $125.66M
44 74176 Computed tomography, abdomen and pelvis; without contrast material $114.67M
45 99282 Emergency department visit for the evaluation and management, low to moderate severity $113.01M
46 70450 Computed tomography, head or brain; without contrast material $112.41M
47 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $111.89M
48 H2011 Crisis intervention service, per 15 minutes $92.34M
49 99215 Prolong outpt/office vis $90.56M
50 99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes $88.49M
51 99223 Prolong inpt eval add15 m $79.03M
52 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $74.15M
53 90460 Immunization administration through 18 years of age via any route, first or only component $73.86M
54 G0378 Hospital observation service, per hour $73.10M
55 S1040 Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) $70.25M
56 S5110 Home care training, family; per 15 minutes $68.17M
57 80307 Drug test(s), presumptive, any number of drug classes; immunoassay $68.06M
58 J0887 Injection, epoetin beta, 1 microgram, (for esrd on dialysis) $66.80M
59 90792 Psychiatric diagnostic evaluation with medical services $65.06M
60 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple $63.87M
61 T2025 Waiver services; not otherwise specified (nos) $62.97M
62 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $61.77M
63 S0209 Wheelchair van, mileage, per mile $61.13M
64 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $59.88M
65 88305 Level IV - Surgical pathology, gross and microscopic examination $57.98M
66 H0025 Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior) $55.06M
67 S9485 Crisis intervention mental health services, per diem $54.44M
68 72125 Computed tomography, cervical spine; without contrast material $53.50M
69 S0201 Partial hospitalization services, less than 24 hours, per diem $52.58M
70 T2019 Habilitation, supported employment, waiver; per 15 minutes $52.49M
71 A0100 Non-emergency transportation; taxi $52.40M
72 99309 Subsequent nursing facility care, per day, low to moderate complexity $49.77M
73 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $49.49M
74 95165 Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials $48.94M
75 T2013 Habilitation, educational, waiver; per hour $47.61M
76 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $47.40M
77 A0436 Rotary wing air mileage, per statute mile $47.34M
78 71275 Computed tomographic angiography, chest, with contrast material $47.10M
79 42820 Tonsillectomy and adenoidectomy; younger than age 12 $46.37M
80 90837 Psychotherapy, 53 minutes with patient $46.03M
81 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $43.79M
82 A0426 Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) $42.75M
83 J9271 Injection, pembrolizumab, 1 mg $42.51M
84 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $42.26M
85 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $41.54M
86 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $41.16M
87 70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences $41.06M
88 C1713 Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) $40.32M
89 D1120 Prophylaxis - child $38.78M
90 E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate $37.99M
91 80053 Comprehensive metabolic panel $37.54M
92 99239 Hospital discharge day management, more than 30 minutes $36.29M
93 77067 Screening mammography, bilateral, including computer-aided detection $35.05M
94 G0299 Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes $34.66M
95 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $32.09M
96 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $31.77M
97 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $31.34M
98 A0431 Ambulance service, conventional air services, transport, one way (rotary wing) $31.12M
99 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $30.21M
100 47562 $30.00M
101 44970 $29.15M
102 H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) $29.00M
103 T1019 Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant) $28.73M
104 V2020 Frames, purchases $28.67M
105 87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism $27.82M
106 99244 Office or other outpatient consultation, moderate to high complexity $27.64M
107 D0120 Periodic oral evaluation - established patient $27.07M
108 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $26.95M
109 95004 Percutaneous tests with allergenic extracts, immediate type reaction $26.41M
110 78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress $25.42M
111 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $25.32M
112 A0130 Non-emergency transportation: wheelchair van $25.10M
113 01967 Neuraxial labor analgesia/anesthesia for planned vaginal delivery $25.03M
114 92508 Group treatment of speech, language, voice, communication, and/or auditory processing disorder $25.00M
115 45380 Colonoscopy, flexible; with biopsy, single or multiple $24.75M
116 80050 General health panel $24.38M
117 93303 Transthoracic echocardiography for congenital cardiac anomalies, follow-up or limited study $24.08M
118 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $23.37M
119 T2012 Habilitation, educational; waiver, per diem $23.08M
120 T2028 Specialized supply, not otherwise specified, waiver $22.82M
121 G0300 Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes $22.74M
122 59400 Routine obstetric care including antepartum care, vaginal delivery, and postpartum care $22.74M
123 76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up $22.30M
124 11042 Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm $22.09M
125 87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms $21.98M
126 H2021 Community-based wrap-around services, per 15 minutes $21.41M
127 B4161 Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $21.36M
128 A0998 Ambulance response and treatment, no transport $21.26M
129 H0016 Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) $21.19M
130 95810 Polysomnography; sleep staging with 4 or more additional parameters $20.96M
131 70551 Magnetic resonance imaging, brain; without contrast material $20.87M
132 90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits $20.67M
133 G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed $20.22M
134 64483 $19.96M
135 99308 Subsequent nursing facility care, per day, straightforward $19.94M
136 T1003 Lpn/lvn services, up to 15 minutes $19.84M
137 H2019 Therapeutic behavioral services, per 15 minutes $19.64M
138 99254 $19.63M
139 96361 Intravenous infusion, hydration; each additional hour $19.48M
140 71045 Radiologic examination, chest; single view $19.04M
141 71046 Radiologic examination, chest; 2 views $18.95M
142 S5151 Unskilled respite care, not hospice; per diem $18.52M
143 T1002 Rn services, up to 15 minutes $18.41M
144 59025 Fetal non-stress test $18.26M
145 36902 $18.11M
146 H2020 Therapeutic behavioral services, per diem $17.89M
147 H0002 Behavioral health screening to determine eligibility for admission to treatment program $17.83M
148 T1021 Home health aide or certified nurse assistant, per visit $17.75M
149 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete $17.63M
150 A9276 Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply $17.10M
151 B4160 Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit $17.07M
152 S5140 Foster care, adult; per diem $16.92M
153 E2510 Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access $16.87M
154 99238 Hospital discharge day management, 30 minutes or less $16.85M
155 99310 Prolong nursin fac eval 15m $16.66M
156 J0585 Injection, onabotulinumtoxina, 1 unit $16.56M
157 87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe $16.51M
158 92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient $16.33M
159 99222 Initial hospital care, per day, moderate complexity $16.15M
160 D2930 Prefabricated stainless steel crown - primary tooth $16.14M
161 A0435 Fixed wing air mileage, per statute mile $15.91M
162 J0574 Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine $15.80M
163 76700 Ultrasound, abdominal, real time with image documentation; complete $15.56M
164 T2040 Financial management, self-directed, waiver; per 15 minutes $15.51M
165 B4035 Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape $15.19M
166 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour $15.18M
167 Q4081 Injection, epoetin alfa, 100 units (for esrd on dialysis) $15.17M
168 D1206 Topical application of fluoride varnish $15.14M
169 76830 Ultrasound, transvaginal $15.12M
170 90791 Psychiatric diagnostic evaluation $15.00M
171 E2402 Negative pressure wound therapy electrical pump, stationary or portable $14.76M
172 72148 Magnetic resonance imaging, lumbar spine; without contrast material $14.74M
173 H2015 Comprehensive community support services, per 15 minutes $14.61M
174 95144 $14.55M
175 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $14.45M
176 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $14.43M
177 97803 $14.36M
178 90853 Group psychotherapy (other than of a multiple-family group) $14.17M
179 69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia $14.03M
180 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $13.80M
181 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $13.65M
182 A4353 Intermittent urinary catheter, with insertion supplies $13.64M
183 76819 Fetal biophysical profile; without non-stress testing $13.61M
184 80061 Lipid panel $13.39M
185 J1745 Injection, infliximab, excludes biosimilar, 10 mg $13.26M
186 93970 $13.25M
187 99205 Prolong outpt/office vis $13.19M
188 A0398 Als routine disposable supplies $13.06M
189 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) $12.94M
190 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation $12.75M
191 99601 $12.71M
192 64635 $12.68M
193 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) $12.67M
194 36478 $12.40M
195 76815 Ultrasound, pregnant uterus, real time with image documentation, limited $12.39M
196 76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed $12.32M
197 T1005 Respite care services, up to 15 minutes $12.25M
198 92526 $12.08M
199 D1110 Prophylaxis - adult $11.96M
200 95811 $11.92M