Data from the U.S. Department of Health and Human Services Medicaid Provider Spending database shows Medicaid providers in Sun City billed $4,482,427 for Medicine Services and Procedures in 2024. That figure represents a 72.8% increase from 2023, when billing reached $2,594,544 for this category.
Medicaid, a public health insurance program overseen by states with both federal and state funding, provides coverage for people with low incomes, seniors, children, and those with disabilities. It is a significant component of the U.S. health care system, serving millions each year. Learn more about its funding here.
Shifts in Medicaid billing at the community level highlight how public health funds are distributed locally, as the program is taxpayer-funded.
The “Medicine Services and Procedures” category includes a defined set of services, grouped under standardized HCPCS and CPT codes. For this analysis, billing codes were categorized using set code prefixes and ranges to maintain consistent comparisons and rankings while avoiding duplication.
Among several areas of increased Medicaid spending, Medicine Services and Procedures placed third for total Medicaid payments in Sun City during 2024.
Statewide, Arizona ranked Medicine Services and Procedures fifth in total Medicaid payments for 2024.
Between 2019 and 2024, Sun City Medicaid payments for Medicine Services and Procedures rose by $2,677,339, equivalent to a 148.3% increase. Notable rises were seen in particular years, including 2021 and 2023.
While payments under the Medicine Services and Procedures category spanned the city, most were concentrated in a few ZIP codes. In 2024, ZIP code 85375 saw $2,535,021 in Medicaid payments for the category, ZIP code 85351 totaled $1,941,387, and ZIP code 85372 recorded $6,018. Altogether, these 3 ZIP codes made up 100% of Sun City’s Medicaid payments for the service group that year.
Payments were also highly concentrated among a smaller group of specific billing codes within the category.
Medicaid Medicine Services and Procedures payments grew 72.8% between 2023 and 2024 in Sun City, while all Medicaid categories in the city grew 10.2% over the same time period.
According to the Centers for Medicare & Medicaid Services, combined federal and state Medicaid spending hit $871.7 billion in fiscal year 2023, comprising approximately 18% of the nation’s health spending. This rose sharply from about $613.5 billion in 2019, before the COVID-19 pandemic.
This change equals nearly 40% growth over several years, fueled by increased enrollment and higher service utilization in the pandemic and post-pandemic period.
Federal budget policy changes during the Trump administration included major proposals that would scale back federal Medicaid funding and modify the program’s structure. The “One Big Beautiful Bill Act,” enacted in 2025, is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. The law also introduces work requirements and higher cost-sharing, which may decrease federal contributions and coverage for some individuals, transferring greater financial responsibility to states.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $1,805,088 | -11% |
| 2021 | $2,160,042 | 19.7% |
| 2022 | $2,299,167 | 6.4% |
| 2023 | $2,594,544 | 12.8% |
| 2024 | $4,482,427 | 72.8% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | Evaluation and Management | $10,607,693 | 44.8% |
| 2 | Radiology Procedures | $4,675,351 | 19.7% |
| 3 | Medicine Services and Procedures | $4,482,427 | 18.9% |
| 4 | Temporary National Codes (Non-Medicare) | $878,793 | 3.7% |
| 5 | Surgery | $859,057 | 3.6% |
| 6 | National Codes Established for State Medicaid Agencies | $747,054 | 3.2% |
| 7 | Ambulance and Other Transport Services and Supplies | $542,479 | 2.3% |
| 8 | Vision Services | $247,058 | 1% |
| 9 | Procedures / Professional Services | $201,340 | 0.9% |
| 10 | Drugs Administered Other than Oral Method | $145,068 | 0.6% |
| 11 | Outpatient PPS | $90,967 | 0.4% |
| 12 | Administrative, Miscellaneous and Investigational | $58,859 | 0.2% |
| 13 | Durable Medical Equipment | $57,396 | 0.2% |
| 14 | Medical And Surgical Supplies | $51,400 | 0.2% |
| 15 | Pathology and Laboratory Procedures | $29,491 | 0.1% |
| 16 | Temporary Codes | $9,886 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 92014 | Compre oph exam est pt 1/> | $861,282 | 23 |
| 92060 | Sensorimotor examination | $730,707 | 19 |
| 92004 | Compre oph exam new pt 1/> | $583,826 | 32 |
| 90999 | Unlisted dialysis procedure | $456,005 | 20 |
| 95715 | Veeg ea 12-26hr intmt mntr | $357,491 | 3 |
| 95816 | Eeg awake and drowsy | $239,709 | 46 |
| 95700 | Eeg cont rec w/vid eeg tech | $222,244 | 8 |
| 92015 | Determine refractive state | $185,779 | 19 |
| 92285 | External ocular photography | $156,401 | 19 |
| 95886 | Musc test done w/n test comp | $112,857 | 47 |
| 96133 | Nrpsyc tst eval phys/qhp ea | $102,085 | 25 |
| 96139 | Psycl/nrpsyc tst tech ea | $69,767 | 24 |
| 93306 | Tte w/doppler complete | $59,145 | 20 |
| 93971 | Extremity study | $47,321 | 13 |
| 96116 | Nubhvl xm phys/qhp 1st hr | $38,833 | 30 |
| 93010 | Electrocardiogram report | $38,244 | 222 |
| 96132 | Nrpsyc tst eval phys/qhp 1st | $35,102 | 25 |
| 95819 | Eeg awake and asleep | $34,368 | 6 |
| 92012 | Intrm oph exam est patient | $32,995 | 12 |
| 96121 | Nubhvl xm phy/qhp ea addl hr | $23,363 | 19 |
Note: HCPCS codes are shown for context within the category. Category totals and rankings in this article are based on standardized service groupings rather than individual billing codes.
Information in this article was obtained from the U.S. Department of Health and Human Services Medicaid Provider Spending database. The source data can be found here.
