Medicaid Provider Spending

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

Billing Codes in Virgin Islands

All 676 procedure codes billed by Medicaid providers in Virgin Islands, ranked by total spending.

#CodeDescriptionTotal Paid
1 99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity $13.85M
2 36415 Collection of venous blood by venipuncture $12.88M
3 99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity $10.70M
4 A0130 Non-emergency transportation: wheelchair van $9.75M
5 D2740 Crown - porcelain/ceramic $8.82M
6 A0430 Ambulance service, conventional air services, transport, one way (fixed wing) $8.59M
7 90999 Unlisted dialysis procedure, inpatient or outpatient $5.56M
8 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) $3.96M
9 A0427 Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) $3.32M
10 D7140 Extraction, erupted tooth or exposed root $2.70M
11 D2392 Resin-based composite - two surfaces, posterior, primary or permanent $2.63M
12 99281 Emergency department visit for the evaluation and management, self-limited or minor $2.56M
13 97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion $2.53M
14 D6750 $2.45M
15 J1642 Injection, heparin sodium, (heparin lock flush), per 10 units $2.38M
16 99282 Emergency department visit for the evaluation and management, low to moderate severity $2.29M
17 90837 Psychotherapy, 53 minutes with patient $2.29M
18 D8080 Comprehensive orthodontic treatment of the adolescent dentition $2.09M
19 80053 Comprehensive metabolic panel $2.06M
20 D2391 Resin-based composite - one surface, posterior, primary or permanent $1.86M
21 87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe $1.84M
22 D3330 Endodontic therapy, molar tooth (excluding final restoration) $1.76M
23 D0150 Comprehensive oral evaluation - new or established patient $1.69M
24 97530 Therapeutic activities, direct patient contact, each 15 minutes $1.66M
25 99215 Prolong outpt/office vis $1.59M
26 D6240 $1.44M
27 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder $1.42M
28 V2020 Frames, purchases $1.39M
29 D2950 $1.38M
30 D1110 Prophylaxis - adult $1.34M
31 99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) $1.33M
32 D0330 Panoramic radiographic image $1.29M
33 D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth $1.28M
34 81003 $1.23M
35 D0140 Limited oral evaluation - problem focused $1.09M
36 96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance $1.04M
37 99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward $1.04M
38 D3320 $1.01M
39 V2200 Sphere, bifocal, plano to plus or minus 4.00d, per lens $996K
40 99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) $995K
41 92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient $935K
42 V2100 Sphere, single vision, plano to plus or minus 4.00, per lens $934K
43 D0210 Intraoral - complete series of radiographic images $934K
44 71046 Radiologic examination, chest; 2 views $886K
45 77067 Screening mammography, bilateral, including computer-aided detection $885K
46 D5214 $885K
47 77063 Screening digital breast tomosynthesis, bilateral $859K
48 D2750 $857K
49 99000 $834K
50 D1120 Prophylaxis - child $811K
51 97153 Adaptive behavior treatment by protocol, administered by technician, each 15 minutes $797K
52 96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular $796K
53 87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe $781K
54 J2501 Injection, paricalcitol, 1 mcg $773K
55 D4341 $742K
56 D1330 $742K
57 D1351 Sealant - per tooth $740K
58 J0882 Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis) $723K
59 Q9962 High osmolar contrast material, 300-349 mg/ml iodine concentration, per ml $697K
60 D0120 Periodic oral evaluation - established patient $690K
61 99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity $676K
62 99283 Emergency department visit for the evaluation and management, moderate severity $643K
63 D0274 Bitewings - four radiographic images $622K
64 99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) $617K
65 80061 Lipid panel $613K
66 87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe $613K
67 85025 Blood count; complete (CBC), automated, and automated differential WBC count $590K
68 84443 Thyroid stimulating hormone (TSH) $578K
69 87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) $572K
70 96158 $571K
71 99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity $567K
72 D9310 $564K
73 76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation $556K
74 90960 End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits $548K
75 99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity $540K
76 D2930 Prefabricated stainless steel crown - primary tooth $511K
77 81025 $502K
78 70450 Computed tomography, head or brain; without contrast material $501K
79 V2755 U-v lens, per lens $488K
80 D2393 Resin-based composite - three surfaces, posterior, primary or permanent $485K
81 D1208 Topical application of fluoride, excluding varnish $450K
82 D0380 $445K
83 93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete $443K
84 D3310 $434K
85 90460 Immunization administration through 18 years of age via any route, first or only component $433K
86 C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source $424K
87 90461 $386K
88 A0425 Ground mileage, per statute mile $378K
89 99218 $376K
90 93922 $371K
91 99354 $370K
92 87811 Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) $365K
93 V2760 Scratch resistant coating, per lens $365K
94 Q4081 Injection, epoetin alfa, 100 units (for esrd on dialysis) $354K
95 D1206 Topical application of fluoride varnish $351K
96 90833 Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) $345K
97 88305 Level IV - Surgical pathology, gross and microscopic examination $337K
98 D5213 $335K
99 83036 Hemoglobin; glycosylated (A1C) $327K
100 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete $317K
101 97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) $316K
102 D4355 $308K
103 D0220 Intraoral - periapical first radiographic image $302K
104 87070 $299K
105 99205 Prolong outpt/office vis $299K
106 88142 $295K
107 J0606 Injection, etelcalcetide, 0.1 mg $292K
108 97155 Adaptive behavior treatment with protocol modification, administered by physician, each 15 minutes $289K
109 87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe $278K
110 87389 Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies $275K
111 D4910 $266K
112 82962 $264K
113 95819 $263K
114 81002 $249K
115 J1644 Injection, heparin sodium, per 1000 units $246K
116 76815 Ultrasound, pregnant uterus, real time with image documentation, limited $225K
117 87086 Culture, bacterial; quantitative colony count, urine $223K
118 98941 Chiropractic manipulative treatment; spinal, 3-4 regions $220K
119 93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report $218K
120 67028 Intravitreal injection of a pharmacologic agent $217K
121 88313 $208K
122 99232 Subsequent hospital care, per day, moderate complexity $207K
123 Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml $203K
124 D9230 Inhalation of nitrous oxide / analgesia, anxiolysis $200K
125 G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source $199K
126 74177 Computed tomography, abdomen and pelvis; with contrast material $198K
127 92004 Ophthalmological services: medical examination and evaluation, comprehensive, new patient $191K
128 G0378 Hospital observation service, per hour $190K
129 D9223 Deep sedation/general anesthesia - each subsequent 15 minute increment $188K
130 99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward $183K
131 97533 $183K
132 97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination $182K
133 V2745 Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens $182K
134 J0131 Injection, acetaminophen, not otherwise specified,10 mg $180K
135 99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) $179K
136 D7250 $178K
137 D1310 $175K
138 83037 $173K
139 D0470 $173K
140 D8660 $171K
141 76830 Ultrasound, transvaginal $164K
142 71045 Radiologic examination, chest; single view $163K
143 87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets $161K
144 84703 $158K
145 D2331 $157K
146 84439 $156K
147 90791 Psychiatric diagnostic evaluation $156K
148 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed $154K
149 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine $151K
150 72148 Magnetic resonance imaging, lumbar spine; without contrast material $145K
151 J2250 Injection, midazolam hydrochloride, per 1 mg $143K
152 99284 Emergency department visit for the evaluation and management, high severity $143K
153 87110 $140K
154 96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour $139K
155 90832 Psychotherapy, 30 minutes with patient $138K
156 G0467 Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit $133K
157 90834 Psychotherapy, 45 minutes with patient $132K
158 92012 Ophthalmological services: medical examination and evaluation, intermediate, established patient $128K
159 93000 $127K
160 J3490 Unclassified drugs $127K
161 74176 Computed tomography, abdomen and pelvis; without contrast material $124K
162 D0230 Intraoral - periapical each additional radiographic image $122K
163 D3221 $122K
164 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis $121K
165 92134 $120K
166 87088 $120K
167 J1050 Injection, medroxyprogesterone acetate, 1 mg $117K
168 92250 $116K
169 86003 $114K
170 59025 Fetal non-stress test $111K
171 88175 Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer $111K
172 73630 $108K
173 G0463 Hospital outpatient clinic visit for assessment and management of a patient $106K
174 86592 $104K
175 31575 $104K
176 D9630 $103K
177 80074 $102K
178 59426 $101K
179 76801 $100K
180 73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material $92K
181 81001 $90K
182 76700 Ultrasound, abdominal, real time with image documentation; complete $90K
183 87800 $89K
184 96110 Developmental screening, with scoring and documentation, per standardized instrument $89K
185 D5110 $87K
186 D4921 $84K
187 94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction $84K
188 82948 $81K
189 87177 $79K
190 D0272 Bitewings - two radiographic images $78K
191 88164 $78K
192 85027 $77K
193 U0001 Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel $75K
194 96131 $74K
195 99442 $68K
196 90785 $67K
197 87210 $67K
198 97803 $66K
199 80048 Basic metabolic panel (calcium, ionized) $66K
200 73030 $65K