{
  "meta": {
    "api_version": "v1",
    "edition": "2026.1",
    "generated_at": "2026-08-23T08:47:59.837Z",
    "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."
  },
  "count": 61,
  "note": "Medicaid paid per claim line by CDT code (2018-2024), derived from HHS T-MSIS Medicaid Provider Spending and geolocated with NPPES. D6010 (implant body) is excluded (1,979 claim lines only). Not a fee schedule.",
  "csv": "https://realdentalcosts.com/data/medicaid-dental-paid-by-state-2018-2024.csv",
  "state_quality": [
    {
      "code": "AL",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 6183549,
      "paid_2023_2024_usd": 183230091
    },
    {
      "code": "AK",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 877442,
      "paid_2023_2024_usd": 74775873
    },
    {
      "code": "AZ",
      "flag": "nominal_amounts_suspected",
      "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$",
      "lines_2023_2024": 8801726,
      "paid_2023_2024_usd": 152977005
    },
    {
      "code": "AR",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 4060011,
      "paid_2023_2024_usd": 151925541
    },
    {
      "code": "CA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 83828701,
      "paid_2023_2024_usd": 2957496095
    },
    {
      "code": "CO",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 6900703,
      "paid_2023_2024_usd": 407297146
    },
    {
      "code": "CT",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 4648909,
      "paid_2023_2024_usd": 184156547
    },
    {
      "code": "DE",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1660376,
      "paid_2023_2024_usd": 114726053
    },
    {
      "code": "DC",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1332283,
      "paid_2023_2024_usd": 60999656
    },
    {
      "code": "FL",
      "flag": "nominal_amounts_suspected",
      "evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 13$ vs US 26$; D1110 median 14$ vs US 47$; D2392 median 33$ vs US 79$; D7140 median 25$ vs US 60$",
      "lines_2023_2024": 23077968,
      "paid_2023_2024_usd": 405848624
    },
    {
      "code": "GA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 12930949,
      "paid_2023_2024_usd": 482737223
    },
    {
      "code": "HI",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1016344,
      "paid_2023_2024_usd": 57756824
    },
    {
      "code": "ID",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1992686,
      "paid_2023_2024_usd": 64643233
    },
    {
      "code": "IL",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 14329126,
      "paid_2023_2024_usd": 535859105
    },
    {
      "code": "IN",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 8936040,
      "paid_2023_2024_usd": 381096399
    },
    {
      "code": "IA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 3262754,
      "paid_2023_2024_usd": 133465756
    },
    {
      "code": "KS",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 2835142,
      "paid_2023_2024_usd": 113151909
    },
    {
      "code": "KY",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 6244864,
      "paid_2023_2024_usd": 285363321
    },
    {
      "code": "LA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 5707440,
      "paid_2023_2024_usd": 247166789
    },
    {
      "code": "ME",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1183066,
      "paid_2023_2024_usd": 53208741
    },
    {
      "code": "MD",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 9559018,
      "paid_2023_2024_usd": 485623222
    },
    {
      "code": "MA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 12609160,
      "paid_2023_2024_usd": 672675182
    },
    {
      "code": "MI",
      "flag": "non_npi_identifiers",
      "evidence": "Michigan reports a large share of Medicaid dental dollars under non-NPI provider identifiers (participation understated).",
      "lines_2023_2024": 12495328,
      "paid_2023_2024_usd": 691016853
    },
    {
      "code": "MN",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 5722646,
      "paid_2023_2024_usd": 386455760
    },
    {
      "code": "MS",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 4656590,
      "paid_2023_2024_usd": 193767271
    },
    {
      "code": "MO",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 5087615,
      "paid_2023_2024_usd": 316807496
    },
    {
      "code": "MT",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1545157,
      "paid_2023_2024_usd": 69347221
    },
    {
      "code": "NE",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 2140277,
      "paid_2023_2024_usd": 73288360
    },
    {
      "code": "NV",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 4517491,
      "paid_2023_2024_usd": 145333278
    },
    {
      "code": "NH",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 823350,
      "paid_2023_2024_usd": 35898096
    },
    {
      "code": "NJ",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 12484977,
      "paid_2023_2024_usd": 383191488
    },
    {
      "code": "NM",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 3892006,
      "paid_2023_2024_usd": 153646561
    },
    {
      "code": "NY",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 28783070,
      "paid_2023_2024_usd": 1039554044
    },
    {
      "code": "NC",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 15875025,
      "paid_2023_2024_usd": 618775330
    },
    {
      "code": "ND",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 260935,
      "paid_2023_2024_usd": 14013613
    },
    {
      "code": "OH",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 11331753,
      "paid_2023_2024_usd": 525905449
    },
    {
      "code": "OK",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 5160641,
      "paid_2023_2024_usd": 231206394
    },
    {
      "code": "OR",
      "flag": "nominal_amounts_suspected",
      "evidence": "Managed-care encounters likely carry nominal paid amounts: D1110 median 15$ vs US 47$; D2392 median 23$ vs US 79$; D7140 median 14$ vs US 60$",
      "lines_2023_2024": 8574575,
      "paid_2023_2024_usd": 146074700
    },
    {
      "code": "PA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 9257235,
      "paid_2023_2024_usd": 356929990
    },
    {
      "code": "RI",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 1522823,
      "paid_2023_2024_usd": 58352536
    },
    {
      "code": "SC",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 5071884,
      "paid_2023_2024_usd": 190880126
    },
    {
      "code": "SD",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 783884,
      "paid_2023_2024_usd": 50145892
    },
    {
      "code": "TN",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 8591071,
      "paid_2023_2024_usd": 302213585
    },
    {
      "code": "TX",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 51449072,
      "paid_2023_2024_usd": 1520902936
    },
    {
      "code": "UT",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 2059103,
      "paid_2023_2024_usd": 78007410
    },
    {
      "code": "VT",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 490069,
      "paid_2023_2024_usd": 22952103
    },
    {
      "code": "VA",
      "flag": "nominal_amounts_suspected",
      "evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 0$ 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$",
      "lines_2023_2024": 8725135,
      "paid_2023_2024_usd": 173391877
    },
    {
      "code": "WA",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 12507291,
      "paid_2023_2024_usd": 464821243
    },
    {
      "code": "WV",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 2822012,
      "paid_2023_2024_usd": 147182243
    },
    {
      "code": "WI",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 4840141,
      "paid_2023_2024_usd": 164545056
    },
    {
      "code": "WY",
      "flag": "ok",
      "evidence": null,
      "lines_2023_2024": 369539,
      "paid_2023_2024_usd": 17326310
    }
  ],
  "codes": [
    {
      "code": "D0120",
      "label": "periodic oral exam",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 30.19,
      "lines_2023_2024": 48171895,
      "states_published": 51,
      "confidence": 75,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0120.json"
    },
    {
      "code": "D0140",
      "label": "problem-focused (limited) exam",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 33.36,
      "lines_2023_2024": 8476933,
      "states_published": 51,
      "confidence": 72,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0140.json"
    },
    {
      "code": "D0145",
      "label": "oral exam, child under 3",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 86.76,
      "lines_2023_2024": 2260294,
      "states_published": 51,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0145.json"
    },
    {
      "code": "D0150",
      "label": "comprehensive oral exam",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 38.95,
      "lines_2023_2024": 15806577,
      "states_published": 51,
      "confidence": 71,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0150.json"
    },
    {
      "code": "D0210",
      "label": "full-mouth x-ray series",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 44.25,
      "lines_2023_2024": 5282128,
      "states_published": 51,
      "confidence": 73,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0210.json"
    },
    {
      "code": "D0220",
      "label": "first periapical x-ray",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 10.73,
      "lines_2023_2024": 30300487,
      "states_published": 51,
      "confidence": 73,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0220.json"
    },
    {
      "code": "D0230",
      "label": "additional periapical x-ray",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 6.75,
      "lines_2023_2024": 56027630,
      "states_published": 51,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0230.json"
    },
    {
      "code": "D0272",
      "label": "two bitewing x-rays",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 17.08,
      "lines_2023_2024": 17379643,
      "states_published": 51,
      "confidence": 72,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0272.json"
    },
    {
      "code": "D0274",
      "label": "four bitewing x-rays",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 24.08,
      "lines_2023_2024": 17790170,
      "states_published": 51,
      "confidence": 73,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0274.json"
    },
    {
      "code": "D0330",
      "label": "panoramic x-ray",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 40.73,
      "lines_2023_2024": 8691110,
      "states_published": 51,
      "confidence": 72,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0330.json"
    },
    {
      "code": "D0350",
      "label": "oral photographs",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 12.71,
      "lines_2023_2024": 5206548,
      "states_published": 49,
      "confidence": 76,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0350.json"
    },
    {
      "code": "D0601",
      "label": "caries risk assessment (low)",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 3.39,
      "lines_2023_2024": 1290737,
      "states_published": 50,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0601.json"
    },
    {
      "code": "D0602",
      "label": "caries risk assessment (moderate)",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 2.77,
      "lines_2023_2024": 1989233,
      "states_published": 50,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0602.json"
    },
    {
      "code": "D0603",
      "label": "caries risk assessment (high)",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 2.88,
      "lines_2023_2024": 10404222,
      "states_published": 51,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D0603.json"
    },
    {
      "code": "D1110",
      "label": "adult teeth cleaning",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 45.17,
      "lines_2023_2024": 21051464,
      "states_published": 51,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1110.json"
    },
    {
      "code": "D1120",
      "label": "child teeth cleaning",
      "procedure_id": "exam",
      "national_paid_per_line_2023_2024_usd": 36.05,
      "lines_2023_2024": 37835612,
      "states_published": 51,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1120.json"
    },
    {
      "code": "D1206",
      "label": "fluoride varnish",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 19.97,
      "lines_2023_2024": 30837684,
      "states_published": 51,
      "confidence": 73,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1206.json"
    },
    {
      "code": "D1208",
      "label": "topical fluoride",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 16.77,
      "lines_2023_2024": 21876834,
      "states_published": 51,
      "confidence": 75,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1208.json"
    },
    {
      "code": "D1351",
      "label": "sealant, per tooth",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 27.88,
      "lines_2023_2024": 24241846,
      "states_published": 51,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1351.json"
    },
    {
      "code": "D1354",
      "label": "silver diamine fluoride, per tooth",
      "procedure_id": null,
      "national_paid_per_line_2023_2024_usd": 21.51,
      "lines_2023_2024": 3681348,
      "states_published": 51,
      "confidence": 69,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D1354.json"
    },
    {
      "code": "D2140",
      "label": "amalgam filling, 1 surface",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 57.2,
      "lines_2023_2024": 743678,
      "states_published": 48,
      "confidence": 77,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2140.json"
    },
    {
      "code": "D2150",
      "label": "amalgam filling, 2 surfaces",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 71.36,
      "lines_2023_2024": 1304012,
      "states_published": 48,
      "confidence": 77,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2150.json"
    },
    {
      "code": "D2330",
      "label": "front-tooth composite filling, 1 surface",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 70.43,
      "lines_2023_2024": 599867,
      "states_published": 50,
      "confidence": 75,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2330.json"
    },
    {
      "code": "D2391",
      "label": "back-tooth composite filling, 1 surface",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 64.12,
      "lines_2023_2024": 8469835,
      "states_published": 51,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2391.json"
    },
    {
      "code": "D2392",
      "label": "back-tooth composite filling, 2 surfaces",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 83.05,
      "lines_2023_2024": 14060673,
      "states_published": 51,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2392.json"
    },
    {
      "code": "D2393",
      "label": "back-tooth composite filling, 3 surfaces",
      "procedure_id": "filling",
      "national_paid_per_line_2023_2024_usd": 102.49,
      "lines_2023_2024": 2319835,
      "states_published": 51,
      "confidence": 73,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2393.json"
    },
    {
      "code": "D2740",
      "label": "porcelain/ceramic crown",
      "procedure_id": "crown",
      "national_paid_per_line_2023_2024_usd": 546.48,
      "lines_2023_2024": 660776,
      "states_published": 45,
      "confidence": 74,
      "url": "https://realdentalcosts.com/api/v1/medicaid/D2740.json"
    },
    {
      "code": "D2750",
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}