Medicaid providers in Sun City West reported $278,002 in claims for Medicine Services and Procedures during 2024, as shown in data from the U.S. Department of Health and Human Services Medicaid Provider Spending database. This figure rose 29.3% compared to 2023, when claims for the same category reached $215,020.
Medicaid operates as a public health insurance initiative managed by each state with funding from both federal and state governments. The program serves low-income households, seniors, children, and people with disabilities, making it a significant segment of the national health care structure.
With Medicaid payments coming from public funds, shifts in local billing reflect how health care resources are spent within communities.
The Medicine Services and Procedures category captures groups of Medicaid-billed services as defined by care type using HCPCS and CPT coding frameworks. For this report, each billing code was categorized based on prefix and numeric range, ensuring related services were grouped to prevent double counting and maintain accurate tracking over time.
While Medicaid expenditures grew among various service categories, Medicine Services and Procedures placed fourth in Sun City West based on total Medicaid payments in 2024.
Throughout Arizona, Medicine Services and Procedures ranked fifth for total Medicaid payments at the statewide level in 2024.
Examining the five years prior to 2024 shows Medicaid payments for Medicine Services and Procedures in Sun City West grew by $52,682, or 15.9%. Periods of faster spending growth reflected notable year-over-year gains in 2022 and 2023.
Though services in the Medicine Services and Procedures category were found across Sun City West, claim payments were mostly distributed among a select group of ZIP codes. The ZIP code with the highest payment in this category in 2024 was 85375, accounting for $278,001. Altogether, the top 1 ZIP code represented 100% of the category’s Medicaid payments in Sun City West that year.
A small range of specific billing codes dominated Medicaid spending within the Medicine Services and Procedures group.
For context, the 29.3% rise for Medicine Services and Procedures from 2023 to 2024 exceeded the 16.2% increase seen across all Medicaid claim categories in the city.
Data from the Centers for Medicare & Medicaid Services shows total state and federal Medicaid spending reached about $871.7 billion in fiscal year 2023, equaling nearly 18% of all U.S. health expenditures — up significantly from around $613.5 billion in 2019, before the COVID-19 outbreak.
This increase signals growth of around 40% over a few years, largely caused by increased enrollment and utilization tied to pandemic trends.
Recent federal budget measures during the Trump administration introduced substantial proposals to modify federal Medicaid contributions and adjust its structure. The “One Big Beautiful Bill Act,” for instance, was enacted in 2025 and is expected to reduce federal Medicaid spending by more than $1 trillion over 10 years. The act also includes requirements such as work mandates and greater cost-sharing, potentially reducing aid and shifting financial responsibility to states, with federal support projected to grow more slowly, even as the program continues serving millions.
| Year | Total Medicaid Payments | % Change From Previous Year |
|---|---|---|
| 2020 | $330,684 | -31.8% |
| 2021 | $220,652 | -33.3% |
| 2022 | $243,856 | 10.5% |
| 2023 | $215,019 | -11.8% |
| 2024 | $278,001 | 29.3% |
| Rank | Category | Medicaid Payments | Share of City Total |
|---|---|---|---|
| 1 | National Codes Established for State Medicaid Agencies | $2,294,894 | 34% |
| 2 | Evaluation and Management | $2,260,963 | 33.5% |
| 3 | Radiology Procedures | $1,342,545 | 19.9% |
| 4 | Medicine Services and Procedures | $278,001 | 4.1% |
| 5 | Ambulance and Other Transport Services and Supplies | $191,521 | 2.8% |
| 6 | Procedures / Professional Services | $164,594 | 2.4% |
| 7 | Surgery | $79,392 | 1.2% |
| 8 | Pathology and Laboratory Procedures | $61,797 | 0.9% |
| 9 | Outpatient PPS | $55,681 | 0.8% |
| 10 | Drugs Administered Other than Oral Method | $13,550 | 0.2% |
| 11 | Temporary Codes | $25 | <0.1% |
| 12 | Administrative, Miscellaneous and Investigational | $0 | <0.1% |
| 12 | Medical And Surgical Supplies | $0 | <0.1% |
| 12 | Prosthetic Procedures | $0 | <0.1% |
| 12 | Temporary National Codes (Non-Medicare) | $0 | <0.1% |
| HCPCS Code | Description | Medicaid Payments | Claims |
|---|---|---|---|
| 90999 | Unlisted dialysis procedure | $92,339 | 9 |
| 93306 | Tte w/doppler complete | $55,278 | 9 |
| 92650 | Aep scr auditory potential | $51,133 | 32 |
| 93971 | Extremity study | $39,401 | 13 |
| 93970 | Extremity study | $14,442 | 6 |
| 95813 | Eeg extnd mntr 61-119 min | $5,705 | 6 |
| 93005 | Electrocardiogram tracing | $4,552 | 12 |
| 96361 | Hydrate iv infusion add-on | $3,719 | 11 |
| 97110 | Therapeutic exercises | $1,801 | 1 |
| 96366 | Ther/proph/diag iv inf addon | $1,649 | 9 |
| 96375 | Tx/pro/dx inj new drug addon | $1,202 | 12 |
| 92557 | Comprehensive hearing test | $1,032 | 3 |
| 96374 | Ther/proph/diag inj iv push | $1,005 | 12 |
| 93976 | Vascular study | $740 | 11 |
| 96360 | Hydration iv infusion init | $688 | 10 |
| 96376 | Tx/pro/dx inj same drug adon | $643 | 12 |
| 96365 | Ther/proph/diag iv inf init | $614 | 12 |
| 93922 | Upr/l xtremity art 2 levels | $563 | 2 |
| 97032 | Appl modality 1+estim ea 15 | $533 | 1 |
| 96372 | Ther/proph/diag inj sc/im | $422 | 11 |
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.
