{
  "meta": {
    "api_version": "v1",
    "edition": "2026.1",
    "generated_at": "2026-09-14T16:02:08.283Z",
    "license": "CC-BY-4.0",
    "license_url": "https://creativecommons.org/licenses/by/4.0/",
    "attribution_required": true,
    "attribution": "Real Dental Costs — https://realdentalcosts.com",
    "doi": "https://doi.org/10.5281/zenodo.20531728",
    "methodology": "https://realdentalcosts.com/en/methodology/",
    "docs": "https://realdentalcosts.com/en/api/",
    "disclaimer": "Independent pricing and market research. NOT medical, dental or insurance advice.",
    "source": "HHS/CMS Medicaid Provider Spending by HCPCS (T-MSIS), version 2026-02-09 (federal government work; attribution by courtesy)",
    "source_url": "https://opendata.hhs.gov/datasets/medicaid-provider-spending/",
    "dataset_doi": "https://doi.org/10.7910/DVN/7F2BZI",
    "dataset": "Medicaid dental paid per claim line by CDT code and state, 2018-2024",
    "geolocation": "Provider NPI (servicing, else billing) joined to NPPES August 2026 practice address; 99.4% of dental lines matched",
    "suppression": "HHS publishes a provider x code x month cell only if >= 12 claim lines AND >= 12 patients",
    "measure": "paid_per_line_wavg = sum(paid)/sum(claim lines); median_cell/p25/p75 = distribution of paid/lines across published cells",
    "period_note": "2024 preliminary; CHIP included; FFS + managed-care encounters; outpatient/professional only",
    "generated": "2026-08-22",
    "generated_by": "scripts/gen_medicaid_paid.py (DuckDB, outside the build)",
    "license_derived": "CC BY 4.0 (Real Dental Costs derived tables)",
    "labels_note": "Procedure labels are Real Dental Costs' own wording; CDT descriptors are copyright ADA and are not reproduced."
  },
  "code": "D2740",
  "label": "porcelain/ceramic crown",
  "label_note": "Procedure label written by Real Dental Costs; CDT code cited by number only (CDT descriptors are © American Dental Association).",
  "price_type": "medicaid_paid",
  "measure": "Medicaid paid amount per claim line (sum of paid / sum of claim lines), USD. Paid ≠ allowed ≠ charge; not a consumer price.",
  "provenance": {
    "price_type": "medicaid_paid",
    "basis": "observed",
    "source_id": "hhs_tmsis_medicaid_provider_spending_2026_02_09",
    "source": "HHS/CMS Medicaid Provider Spending by HCPCS (T-MSIS), v2026-02-09; provider NPI → state via NPPES (Aug 2026)",
    "source_url": "https://opendata.hhs.gov/datasets/medicaid-provider-spending/",
    "observation_type": "Medicaid paid per claim line, code D2740 (FFS + managed-care encounters + CHIP; cells suppressed below 12 lines / 12 patients)",
    "period": "2023-2024",
    "period_end": "2024-12",
    "sample_n": 660776,
    "geo_level": "national",
    "updated": "2026-08-23",
    "modeled": false,
    "confidence": 74,
    "confidence_note": "Paid amount per claim line, not an allowed amount or a consumer price; managed-care states may report nominal amounts; 2024 is preliminary."
  },
  "national": {
    "period": "2023-2024",
    "paid_per_line_wavg": 546.48,
    "median_cell": 481.56,
    "p25": 474.3,
    "p75": 693.41,
    "lines": 660776,
    "patients": 412609,
    "n_providers": 2736,
    "n_cells": 19295,
    "by_year": {
      "2018": {
        "paid_per_line_wavg": 419.53,
        "median_cell": 430.79,
        "p25": 378.91,
        "p75": 519.08,
        "lines": 13586,
        "patients": 8763,
        "n_providers": 160,
        "n_cells": 506
      },
      "2019": {
        "paid_per_line_wavg": 412.52,
        "median_cell": 450.38,
        "p25": 365.59,
        "p75": 476,
        "lines": 17911,
        "patients": 12228,
        "n_providers": 222,
        "n_cells": 712
      },
      "2020": {
        "paid_per_line_wavg": 408.5,
        "median_cell": 440.9,
        "p25": 301.66,
        "p75": 460,
        "lines": 18007,
        "patients": 12733,
        "n_providers": 247,
        "n_cells": 735
      },
      "2021": {
        "paid_per_line_wavg": 483.99,
        "median_cell": 460,
        "p25": 367.5,
        "p75": 621,
        "lines": 40970,
        "patients": 29053,
        "n_providers": 537,
        "n_cells": 1569
      },
      "2022": {
        "paid_per_line_wavg": 564.91,
        "median_cell": 587.26,
        "p25": 464.29,
        "p75": 705.59,
        "lines": 133441,
        "patients": 86459,
        "n_providers": 1008,
        "n_cells": 4246
      },
      "2023": {
        "paid_per_line_wavg": 548.41,
        "median_cell": 479.45,
        "p25": 471.75,
        "p75": 680,
        "lines": 288976,
        "patients": 185501,
        "n_providers": 1744,
        "n_cells": 8505
      },
      "2024": {
        "paid_per_line_wavg": 544.98,
        "median_cell": 482.62,
        "p25": 476,
        "p75": 705.3,
        "lines": 371800,
        "patients": 227108,
        "n_providers": 2271,
        "n_cells": 10790
      }
    }
  },
  "cash_benchmark": {
    "procedure_id": "crown",
    "procedure_slug": "dental-crown",
    "label": "Dental crown",
    "national_low_usd": 1046,
    "national_avg_usd": 1369,
    "national_high_usd": 2331,
    "basis": "observed",
    "url": "https://realdentalcosts.com/api/v1/procedure/dental-crown.json",
    "ratio_cash_avg_to_medicaid_paid": 2.5
  },
  "states": [
    {
      "state": "Alaska",
      "code": "AK",
      "quality_flag": "ok",
      "quality_evidence": null,
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        "paid_per_line_wavg": 385.53,
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        "n_cells": 58
      },
      "confidence": 76,
      "official_fee": {
        "price_type": "official_fee",
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        "fee_alt_label": null,
        "effective_date": "2026-01-01",
        "source_url": "https://extranet-sp.dhss.alaska.gov/hcs/medicaidalaska/Provider/Fee_Schedules/Fee_Schedule_Dental_FY2026.pdf",
        "source_kind": "pdf",
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        "ada_index_as_of": "2025-09-01",
        "column_note": "single fee column",
        "ratio_fee_to_paid": 2.14
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      "by_year": {
        "2018": {
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          "lines": 1105,
          "patients": 398,
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        },
        "2019": {
          "paid_per_line_wavg": 493.23,
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          "lines": 751,
          "patients": 378,
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        "2020": {
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          "p25": 427.18,
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        },
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          "paid_per_line_wavg": 575.63,
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          "p75": 678.39,
          "lines": 814,
          "patients": 447,
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          "n_cells": 28
        },
        "2022": {
          "paid_per_line_wavg": 623.08,
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          "lines": 789,
          "patients": 575,
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          "paid_per_line_wavg": 461.77,
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          "lines": 452,
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        },
        "2024": {
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        }
      }
    },
    {
      "state": "Alabama",
      "code": "AL",
      "quality_flag": "ok",
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      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 348.36,
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        "lines": 2763,
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        "n_cells": 87
      },
      "confidence": 81,
      "official_fee": {
        "price_type": "official_fee",
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        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2025-10-01",
        "source_url": "https://medicaid.alabama.gov/content/Gated/7.3G_Fee_Schedules/7.3G_Dental_Fee_Schedule_10-1-25.pdf",
        "source_kind": "pdf",
        "sha256": "54735bd348635683d2ff3b418124d15178d2eb13bb7e0d1cd1050964171a59b5",
        "ada_index_as_of": "2025-09-01",
        "column_note": "single fee column",
        "ratio_fee_to_paid": 1.54
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      "by_year": {
        "2018": {
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          "lines": 84,
          "patients": 28,
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        },
        "2019": {
          "paid_per_line_wavg": 394.53,
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          "lines": 43,
          "patients": 26,
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        },
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        },
        "2022": {
          "paid_per_line_wavg": 315.02,
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        "2023": {
          "paid_per_line_wavg": 357.55,
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          "p25": 309.07,
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          "patients": 706,
          "n_providers": 10,
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        "2024": {
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          "lines": 1506,
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      }
    },
    {
      "state": "Arizona",
      "code": "AZ",
      "quality_flag": "nominal_amounts_suspected",
      "quality_evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 7$ vs US 26$; D1110 median 14$ vs US 47$; D2392 median 33$ vs US 79$",
      "latest": {
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        "paid_per_line_wavg": 390.74,
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      "official_fee": {
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        "effective_date": "2026-07-01",
        "source_url": "https://www.azahcccs.gov/PlansProviders/Downloads/FFSrates/Dental/FY26_DentalRates_07012026.xlsx",
        "source_kind": "xlsx",
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        "ada_index_as_of": "2025-09-01",
        "column_note": "fee_usd = statewide FFS rate; fee_alt_usd = Flagstaff rate when different; source = AHCCCS Dental FFS schedule effective 2026-07-01; BR (By Report) = null",
        "ratio_fee_to_paid": 1.42
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          "p25": 22.92,
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    {
      "state": "California",
      "code": "CA",
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      "official_fee": {
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        "fee_usd": 340,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2026-05-01",
        "source_url": "https://dental.dhcs.ca.gov/MCD_documents/providers/provider_handbook/PHB_section_05_MOC_SMA.pdf",
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        "sha256": "b3ceb0b63413c5c3cb873b4864ea8a0fcaac28b1ff89e7716e013b7fe442dd71",
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          "n_providers": 4,
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        "2019": {
          "paid_per_line_wavg": 437.9,
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          "lines": 1968,
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        "2022": {
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          "lines": 17586,
          "patients": 12168,
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        },
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          "lines": 102454,
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    },
    {
      "state": "Colorado",
      "code": "CO",
      "quality_flag": "ok",
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      "latest": {
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        "lines": 50790,
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      "confidence": 80,
      "official_fee": {
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        "fee_usd": 703.19,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2026-07-01",
        "source_url": "https://www.dentaquest.com/content/dam/dentaquest/en/providers/colorado/co-standard-dental-fee-schedule.pdf.coredownload.inline.pdf",
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        "sha256": "d3ca26ff59a12fa48ed081163e084b8b6b04fc04ae3ababdda5c5821e1933f9a",
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      "by_year": {
        "2018": {
          "paid_per_line_wavg": 416,
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          "p25": 399.43,
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          "lines": 1283,
          "patients": 1124,
          "n_providers": 32,
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        "2019": {
          "paid_per_line_wavg": 451.71,
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          "p25": 428.45,
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          "lines": 2368,
          "patients": 1675,
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        "2020": {
          "paid_per_line_wavg": 439.61,
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          "p25": 425.83,
          "p75": 448.17,
          "lines": 2628,
          "patients": 2079,
          "n_providers": 50,
          "n_cells": 140
        },
        "2021": {
          "paid_per_line_wavg": 449.37,
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          "p25": 428.44,
          "p75": 459.37,
          "lines": 3836,
          "patients": 3221,
          "n_providers": 76,
          "n_cells": 222
        },
        "2022": {
          "paid_per_line_wavg": 449.91,
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          "p25": 432.16,
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          "lines": 4213,
          "patients": 3494,
          "n_providers": 83,
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        },
        "2023": {
          "paid_per_line_wavg": 479.9,
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          "p25": 460.5,
          "p75": 482.62,
          "lines": 9371,
          "patients": 6664,
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          "n_cells": 404
        },
        "2024": {
          "paid_per_line_wavg": 710.22,
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          "p25": 482.62,
          "p75": 849.16,
          "lines": 41419,
          "patients": 20320,
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        }
      }
    },
    {
      "state": "Connecticut",
      "code": "CT",
      "quality_flag": "ok",
      "quality_evidence": null,
      "latest": {
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        "paid_per_line_wavg": 666.1,
        "median_cell": 708.4,
        "p25": 642.82,
        "p75": 732.18,
        "lines": 4385,
        "patients": 2682,
        "n_providers": 16,
        "n_cells": 135
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      "confidence": 85,
      "official_fee": null,
      "by_year": {
        "2018": {
          "paid_per_line_wavg": 383.2,
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          "p25": 369.81,
          "p75": 395.73,
          "lines": 712,
          "patients": 285,
          "n_providers": 2,
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        },
        "2020": {
          "paid_per_line_wavg": 701.54,
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          "p25": 701.54,
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          "lines": 14,
          "patients": 12,
          "n_providers": 1,
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        },
        "2021": {
          "paid_per_line_wavg": 649.32,
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          "lines": 133,
          "patients": 87,
          "n_providers": 5,
          "n_cells": 6
        },
        "2022": {
          "paid_per_line_wavg": 646.3,
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          "p25": 658.54,
          "p75": 731.33,
          "lines": 2301,
          "patients": 1273,
          "n_providers": 16,
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          "lines": 22,
          "patients": 12,
          "n_providers": 1,
          "n_cells": 1
        },
        "2020": {
          "paid_per_line_wavg": 447.97,
          "median_cell": 448.17,
          "p25": 444.67,
          "p75": 448.17,
          "lines": 109,
          "patients": 92,
          "n_providers": 2,
          "n_cells": 6
        },
        "2021": {
          "paid_per_line_wavg": 357.77,
          "median_cell": 405.12,
          "p25": 310.08,
          "p75": 444.31,
          "lines": 1099,
          "patients": 541,
          "n_providers": 10,
          "n_cells": 35
        },
        "2022": {
          "paid_per_line_wavg": 405.59,
          "median_cell": 442.13,
          "p25": 385.3,
          "p75": 462.6,
          "lines": 749,
          "patients": 420,
          "n_providers": 10,
          "n_cells": 31
        },
        "2023": {
          "paid_per_line_wavg": 535.24,
          "median_cell": 565.49,
          "p25": 476.12,
          "p75": 578.08,
          "lines": 1476,
          "patients": 944,
          "n_providers": 12,
          "n_cells": 44
        },
        "2024": {
          "paid_per_line_wavg": 698.37,
          "median_cell": 754.78,
          "p25": 482.62,
          "p75": 843.43,
          "lines": 2049,
          "patients": 946,
          "n_providers": 7,
          "n_cells": 46
        }
      }
    },
    {
      "state": "Virginia",
      "code": "VA",
      "quality_flag": "nominal_amounts_suspected",
      "quality_evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 0$ vs US 26$; D1110 median 0$ vs US 47$; D2392 median 0$ vs US 79$; D2740 median 0$ vs US 482$; D7140 median 0$ vs US 60$",
      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 109.8,
        "median_cell": 0,
        "p25": 0,
        "p75": 0,
        "lines": 26224,
        "patients": 15371,
        "n_providers": 133,
        "n_cells": 811
      },
      "confidence": 86,
      "official_fee": {
        "price_type": "official_fee",
        "fee_usd": 669.5,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2024-07-01",
        "source_url": "https://www.dmas.virginia.gov/media/wa4jhogz/va-cardinal-care-smiles-fee-schedule-070124_final.pdf",
        "source_kind": "pdf",
        "sha256": "e9dc411ee3fcf7d7a24535fb7279b42d39f90a94d780cfed28da53756017edb5",
        "ada_index_as_of": "2025-09-01",
        "column_note": "single fee column",
        "ratio_fee_to_paid": 6.1
      },
      "by_year": {
        "2018": {
          "paid_per_line_wavg": 403.52,
          "median_cell": 416.52,
          "p25": 372.5,
          "p75": 423.59,
          "lines": 76,
          "patients": 71,
          "n_providers": 1,
          "n_cells": 5
        },
        "2019": {
          "paid_per_line_wavg": 434.27,
          "median_cell": 433.11,
          "p25": 429.77,
          "p75": 436.44,
          "lines": 46,
          "patients": 29,
          "n_providers": 2,
          "n_cells": 2
        },
        "2020": {
          "paid_per_line_wavg": 448.06,
          "median_cell": 448.17,
          "p25": 430.78,
          "p75": 452.7,
          "lines": 120,
          "patients": 94,
          "n_providers": 2,
          "n_cells": 7
        },
        "2021": {
          "paid_per_line_wavg": 477.01,
          "median_cell": 500,
          "p25": 471.76,
          "p75": 500,
          "lines": 1165,
          "patients": 819,
          "n_providers": 17,
          "n_cells": 52
        },
        "2022": {
          "paid_per_line_wavg": 562.83,
          "median_cell": 529.63,
          "p25": 500,
          "p75": 650,
          "lines": 4205,
          "patients": 2985,
          "n_providers": 48,
          "n_cells": 183
        },
        "2023": {
          "paid_per_line_wavg": 319.15,
          "median_cell": 463.82,
          "p25": 0,
          "p75": 650,
          "lines": 7004,
          "patients": 4737,
          "n_providers": 61,
          "n_cells": 262
        },
        "2024": {
          "paid_per_line_wavg": 33.51,
          "median_cell": 0,
          "p25": 0,
          "p75": 0,
          "lines": 19220,
          "patients": 10634,
          "n_providers": 121,
          "n_cells": 549
        }
      }
    },
    {
      "state": "Vermont",
      "code": "VT",
      "quality_flag": "ok",
      "quality_evidence": null,
      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 101.44,
        "median_cell": 0,
        "p25": 0,
        "p75": 238,
        "lines": 61,
        "patients": 39,
        "n_providers": 2,
        "n_cells": 3
      },
      "confidence": 65,
      "official_fee": {
        "price_type": "official_fee",
        "fee_usd": 891.75,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": null,
        "source_url": "https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/advocacy/medicaid/medicaid-fee-schedule/medicaid_fee_schedule_2025_vt.pdf?rev=a18d1d053c9c41d48c781c0fff7af085&hash=C184A1461A641F9383A222C42A7799C0",
        "source_kind": "pdf",
        "sha256": "7457476d493d29ed9252f8b8048ac3876245f5397681efbc32f7350461029429",
        "ada_index_as_of": "2025-09-01",
        "column_note": "single fee column",
        "ratio_fee_to_paid": 8.79
      },
      "by_year": {
        "2022": {
          "paid_per_line_wavg": 455.78,
          "median_cell": 455.78,
          "p25": 445.87,
          "p75": 465.69,
          "lines": 36,
          "patients": 29,
          "n_providers": 1,
          "n_cells": 2
        },
        "2023": {
          "paid_per_line_wavg": 476,
          "median_cell": 476,
          "p25": 476,
          "p75": 476,
          "lines": 13,
          "patients": 12,
          "n_providers": 1,
          "n_cells": 1
        },
        "2024": {
          "paid_per_line_wavg": 0,
          "median_cell": 0,
          "p25": 0,
          "p75": 0,
          "lines": 48,
          "patients": 27,
          "n_providers": 1,
          "n_cells": 2
        }
      }
    },
    {
      "state": "Washington",
      "code": "WA",
      "quality_flag": "ok",
      "quality_evidence": null,
      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 463.7,
        "median_cell": 476,
        "p25": 476,
        "p75": 606.71,
        "lines": 754,
        "patients": 537,
        "n_providers": 5,
        "n_cells": 26
      },
      "confidence": 82,
      "official_fee": null,
      "by_year": {
        "2018": {
          "paid_per_line_wavg": 80.56,
          "median_cell": 0,
          "p25": 0,
          "p75": 97.34,
          "lines": 58,
          "patients": 43,
          "n_providers": 2,
          "n_cells": 3
        },
        "2019": {
          "paid_per_line_wavg": 149.38,
          "median_cell": 0,
          "p25": 0,
          "p75": 347.46,
          "lines": 119,
          "patients": 79,
          "n_providers": 3,
          "n_cells": 6
        },
        "2020": {
          "paid_per_line_wavg": 514.58,
          "median_cell": 619.96,
          "p25": 510.78,
          "p75": 627.94,
          "lines": 240,
          "patients": 216,
          "n_providers": 3,
          "n_cells": 13
        },
        "2021": {
          "paid_per_line_wavg": 470.29,
          "median_cell": 627.67,
          "p25": 0,
          "p75": 662.79,
          "lines": 506,
          "patients": 421,
          "n_providers": 5,
          "n_cells": 27
        },
        "2022": {
          "paid_per_line_wavg": 495.91,
          "median_cell": 572.72,
          "p25": 380.14,
          "p75": 642.02,
          "lines": 469,
          "patients": 374,
          "n_providers": 5,
          "n_cells": 21
        },
        "2023": {
          "paid_per_line_wavg": 520.71,
          "median_cell": 606.02,
          "p25": 476,
          "p75": 645.59,
          "lines": 245,
          "patients": 201,
          "n_providers": 4,
          "n_cells": 13
        },
        "2024": {
          "paid_per_line_wavg": 436.26,
          "median_cell": 476,
          "p25": 476,
          "p75": 476,
          "lines": 509,
          "patients": 336,
          "n_providers": 3,
          "n_cells": 13
        }
      }
    },
    {
      "state": "Wisconsin",
      "code": "WI",
      "quality_flag": "ok",
      "quality_evidence": null,
      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 599.17,
        "median_cell": 482.62,
        "p25": 312.83,
        "p75": 778.22,
        "lines": 1390,
        "patients": 903,
        "n_providers": 7,
        "n_cells": 42
      },
      "confidence": 78,
      "official_fee": {
        "price_type": "official_fee",
        "fee_usd": 421.6,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2026-01-01",
        "source_url": "https://www.forwardhealth.wi.gov/WIPortal/Subsystem/Publications/MaxFeeDownload.aspx",
        "source_kind": "csv",
        "sha256": "11b6db1fe22c436f1923fc46a8642bc7e8651e49f47ea119bff8c4c7af6ecbf9",
        "ada_index_as_of": "2025-09-01",
        "column_note": "fee_usd = general dentist rate (ForwardHealth PT 27, adult 21+, no BAF/modifier); fee_alt_usd = child rate when different (age band in label); source = ForwardHealth Max Fee extract 2026-09-05; effective_date = latest active rate begin date (per-code date in fee_effective; most rates unchanged since 2022-01-01)",
        "ratio_fee_to_paid": 0.7
      },
      "by_year": {
        "2020": {
          "paid_per_line_wavg": 547.05,
          "median_cell": 545.44,
          "p25": 534.36,
          "p75": 554.53,
          "lines": 53,
          "patients": 44,
          "n_providers": 1,
          "n_cells": 3
        },
        "2021": {
          "paid_per_line_wavg": 664.93,
          "median_cell": 664.93,
          "p25": 664.93,
          "p75": 664.93,
          "lines": 18,
          "patients": 16,
          "n_providers": 1,
          "n_cells": 1
        },
        "2022": {
          "paid_per_line_wavg": 281.09,
          "median_cell": 547.19,
          "p25": 355.82,
          "p75": 600.39,
          "lines": 299,
          "patients": 51,
          "n_providers": 2,
          "n_cells": 3
        },
        "2023": {
          "paid_per_line_wavg": 477.12,
          "median_cell": 482.62,
          "p25": 300.84,
          "p75": 638.16,
          "lines": 374,
          "patients": 272,
          "n_providers": 5,
          "n_cells": 15
        },
        "2024": {
          "paid_per_line_wavg": 644.1,
          "median_cell": 638.33,
          "p25": 399.26,
          "p75": 816.55,
          "lines": 1016,
          "patients": 631,
          "n_providers": 5,
          "n_cells": 27
        }
      }
    },
    {
      "state": "West Virginia",
      "code": "WV",
      "quality_flag": "ok",
      "quality_evidence": null,
      "latest": {
        "period": "2023-2024",
        "paid_per_line_wavg": 601.72,
        "median_cell": 614.39,
        "p25": 556.22,
        "p75": 664.57,
        "lines": 2344,
        "patients": 1515,
        "n_providers": 12,
        "n_cells": 92
      },
      "confidence": 84,
      "official_fee": {
        "price_type": "official_fee",
        "fee_usd": 745.09,
        "fee_alt_usd": null,
        "fee_alt_label": null,
        "effective_date": "2026-04-01",
        "source_url": "https://bms.wv.gov/media/41077/download?inline",
        "source_kind": "pdf",
        "sha256": "6269fbbfe42fe7ba51e554d0c29fc0379201617a72aeb6a22b632d0266bdb629",
        "ada_index_as_of": "2025-09-01",
        "column_note": "single fee column",
        "ratio_fee_to_paid": 1.24
      },
      "by_year": {
        "2018": {
          "paid_per_line_wavg": 421.39,
          "median_cell": 424.91,
          "p25": 413.62,
          "p75": 430.97,
          "lines": 69,
          "patients": 65,
          "n_providers": 1,
          "n_cells": 4
        },
        "2019": {
          "paid_per_line_wavg": 432.76,
          "median_cell": 451.13,
          "p25": 433.18,
          "p75": 452.7,
          "lines": 96,
          "patients": 75,
          "n_providers": 1,
          "n_cells": 5
        },
        "2020": {
          "paid_per_line_wavg": 433.64,
          "median_cell": 434.72,
          "p25": 430.34,
          "p75": 441.86,
          "lines": 126,
          "patients": 103,
          "n_providers": 1,
          "n_cells": 7
        },
        "2021": {
          "paid_per_line_wavg": 437.4,
          "median_cell": 447.55,
          "p25": 416.35,
          "p75": 450.3,
          "lines": 93,
          "patients": 82,
          "n_providers": 1,
          "n_cells": 5
        },
        "2022": {
          "paid_per_line_wavg": 494.68,
          "median_cell": 465.1,
          "p25": 446.78,
          "p75": 514.68,
          "lines": 285,
          "patients": 206,
          "n_providers": 3,
          "n_cells": 15
        },
        "2023": {
          "paid_per_line_wavg": 607.58,
          "median_cell": 618.47,
          "p25": 542.17,
          "p75": 661.83,
          "lines": 871,
          "patients": 616,
          "n_providers": 10,
          "n_cells": 39
        },
        "2024": {
          "paid_per_line_wavg": 598.26,
          "median_cell": 608.17,
          "p25": 559.53,
          "p75": 671.63,
          "lines": 1473,
          "patients": 899,
          "n_providers": 10,
          "n_cells": 53
        }
      }
    }
  ],
  "caveats": [
    "Paid amount per claim line, not an allowed amount, a fee-schedule rate or a cash price.",
    "Managed-care encounters may carry nominal paid amounts in some states (see quality_flag).",
    "HHS suppresses cells below 12 claim lines or 12 patients: provider participation is a floor, small states are incomplete.",
    "Provider state = current NPPES practice address (Aug 2026), not the address at time of service.",
    "2024 data are preliminary. CHIP included. No dual-eligible / third-party-liability flags.",
    "States may use non-NPI provider identifiers (notably Michigan): those dollars cannot be geolocated.",
    "official_fee (where present) is the state's published Medicaid dental fee-for-service rate for this code (source_url, sha256, effective_date attached); it is not what was paid per claim line and the two differ by design (managed care, bundling, rate years)."
  ]
}