Who Medicaid paid,
line by line.
617,503 providers billed Medicaid $1.09T in outpatient and professional claims from January 2018 through December 2024. Every one of them is here, searchable by name or NPI.
The biggest line on Medicaid's bill isn't a doctor visit
The twelve largest billing codes by dollars paid, 2018–2024. See any state's codes or open a code for the providers who bill it.
T1019 is personal care: an aide helping someone bathe, get dressed, eat, and get around their own home, billed in fifteen-minute units. Medicaid paid $122.74B on it, nearly twice the $62.92B spent on the two most common doctor's office visits combined.
It is how Medicaid pays for long-term care at home instead of in a nursing home, and because it is billed by the quarter hour, the hours pile up. Much of it is billed by agencies and by fiscal intermediaries that pay family caregivers, which is why so many of the largest "providers" in this file are companies you've never heard of.
Who sent the bill
Of every dollar in this file, 33¢ went to agencies — home-care companies, case managers, community-support programs — and 11¢ to physicians.
Grouped by each billing NPI's primary provider type in NPPES (the NUCC taxonomy). The billing provider is whoever submitted the claim and got paid, which is not always who did the work.
What this file can't see
Medicaid cost about $872 billion in 2023. This file accounts for $198.79B of it — roughly 23¢ on the dollar.
The HHS release covers outpatient and professional claims only, from fee-for-service, managed care and CHIP. It leaves out inpatient hospital stays, most nursing-home care, prescription drugs (published separately), and the part of managed-care payments that stays with the plans. So a hospital's page here shows its outpatient billing, not its total Medicaid revenue. 2023 total: CMS National Health Expenditure accounts.
Seven years, month by month
Monthly payments nearly doubled from 2018 to 2024. The drop at the very end is not a cut: providers have months to file, so the last weeks of 2024 were still coming in. Treat 2024 totals on any page here as incomplete.
By state
Totals follow population and how each state runs its program; a state whose spending flows mostly through inpatient or plan payments will look small here. By the billing provider's NPPES address.
All states as a list
| State | Paid 2018–2024 |
|---|---|
| New York | $144.77B |
| California | $129.43B |
| Texas | $56.23B |
| Massachusetts | $56.03B |
| New Jersey | $46.95B |
| Michigan | $38.86B |
| Ohio | $36.98B |
| North Carolina | $34.82B |
| Florida | $34.03B |
| Arizona | $33.08B |
| Virginia | $29.49B |
| Missouri | $28.01B |
| Pennsylvania | $27.88B |
| Minnesota | $25.25B |
| Kentucky | $23.53B |
| Colorado | $21.60B |
| Tennessee | $20.40B |
| Illinois | $19.86B |
| Louisiana | $19.38B |
| Maryland | $18.88B |
| Indiana | $17.40B |
| Washington | $16.65B |
| Connecticut | $14.00B |
| New Mexico | $13.69B |
| Iowa | $11.67B |
| Alabama | $10.35B |
| South Carolina | $10.34B |
| Mississippi | $10.06B |
| Wisconsin | $9.81B |
| Oklahoma | $9.49B |
| Maine | $9.49B |
| West Virginia | $8.56B |
| Arkansas | $8.47B |
| Kansas | $8.40B |
| Nevada | $8.07B |
| Oregon | $7.72B |
| Rhode Island | $6.93B |
| Alaska | $6.18B |
| District of Columbia | $6.11B |
| New Hampshire | $5.99B |
| Georgia | $5.79B |
| Montana | $5.37B |
| Utah | $5.20B |
| Delaware | $3.97B |
| Idaho | $3.55B |
| Puerto Rico | $3.23B |
| Hawaii | $3.00B |
| Vermont | $2.97B |
| South Dakota | $2.51B |
| Nebraska | $2.33B |
| North Dakota | $2.16B |
| Wyoming | $898.82M |
| Virgin Islands | $185.84M |
| Guam | $124.28M |
The largest billing providers
| # | Provider | Type | Location | Claims | Paid |
|---|---|---|---|---|---|
| 1 | PUBLIC PARTNERSHIPS LLC | Agency | Latham, NY | 89,773,441 | $7.18B |
| 2 | LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH | Hospital | Los Angeles, CA | 30,870,976 | $6.78B |
| 3 | TEMPUS UNLIMITED, INC. | Agency | Stoughton, MA | 63,523,750 | $5.57B |
| 4 | MODIVCARE SOLUTIONS, LLC | Transport | Denver, CO | 107,716,418 | $3.09B |
| 5 | FREEDOM CARE LLC | Agency | New Hyde Park, NY | 21,977,069 | $3.03B |
| 6 | GUARDIANTRAC. LLC | Agency | Sturgis, MI | 35,557,539 | $2.68B |
| 7 | DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, STATE OF TN | Agency | Nashville, TN | 16,349,155 | $2.60B |
| 8 | ALABAMA DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION | Agency | Montgomery, AL | 1,950,098 | $2.25B |
| 9 | CONSUMER DIRECT CARE NETWORK VIRGINIA | Missoula, MT | 22,162,533 | $2.11B | |
| 10 | COUNTY OF SANTA CLARA | Clinic | San Jose, CA | 4,656,205 | $1.73B |
| 11 | AMERICAN BUSINESS INSTITUTE CORP | Agency | Flushing, NY | 11,238,391 | $1.68B |
| 12 | PREMIER HOME HEALTH CARE SERVICES INC | Agency | New York, NY | 7,928,022 | $1.48B |
| 13 | DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES, STATE OF TN | Agency | Nashville, TN | 5,287,026 | $1.45B |
| 14 | ASSISTCAREHOME HEALTHCARE SERVICES | Agency | Brooklyn, NY | 9,386,423 | $1.44B |
| 15 | LABORATORY CORPORATION OF AMERICA HOLDINGS | Lab | Burlington, NC | 103,910,314 | $1.44B |
| 16 | COUNTY OF RIVERSIDE | Agency | Riverside, CA | 8,714,521 | $1.40B |
| 17 | DEPARTMENT OF DEVELOPMENTAL SERVICES | Agency | Southbridge, MA | 1,662,383 | $1.35B |
| 18 | CITY & COUNTY OF SAN FRANCISCO | Agency | San Francisco, CA | 6,184,815 | $1.34B |
| 19 | COMPASS HEALTH, INC. | Agency | Clinton, MO | 10,541,518 | $1.28B |
| 20 | CITY OF CHICAGO | Chicago, IL | 1,593,649 | $1.23B | |
| 21 | COMMONWEALTH OF MASSACHUSETS | Agency | Beverly, MA | 1,557,105 | $1.14B |
| 22 | LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH | Agency | Alhambra, CA | 14,999,665 | $1.13B |
| 23 | NAE EDISON LLC | Agency | Brooklyn, NY | 6,915,432 | $1.11B |
| 24 | HEART TO HEART HOME CARE, INC. | Agency | Brooklyn, NY | 7,622,845 | $1.10B |
| 25 | COMMONWEALTH OF MASS-DDS | Agency | Hyde Park, MA | 1,432,892 | $1.10B |
| 26 | MARKS HOMECARE AGENCY INC | Agency | Corona, NY | 6,692,707 | $1.08B |
| 27 | YALE NEW HAVEN HOSPITAL | Hospital | New Haven, CT | 23,557,851 | $1.08B |
| 28 | NEW PARTNERS, INC | Agency | New York, NY | 5,875,713 | $1.08B |
| 29 | DEPARTMENT OF HEALTH AND SENIOR SERVICES | Trenton, NJ | 3,312,341 | $1.07B | |
| 30 | ALAMEDA COUNTY BEHAVIORAL HEALTH CARE | Agency | Oakland, CA | 6,138,417 | $1.07B |
| 31 | CONCEPTS OF INDEPENDENCE, INC. | Agency | New York, NY | 5,015,054 | $1.06B |
| 32 | ACUMEN FISCAL AGENT LLC | Mesa, AZ | 10,544,174 | $1.06B | |
| 33 | COUNTY OF SAN BERNARDINO | Clinic | San Bernardino, CA | 6,532,613 | $1.05B |
| 34 | COMMUNITY ASSISTANCE RESOURCES & EXTENDED SERVICES INC | Agency | New York, NY | 2,757,160 | $1.04B |
| 35 | STAVROS CENTER FOR INDEPENDENT LIVING, INC. | Agency | Amherst, MA | 11,206,578 | $1.04B |
| 36 | HEALTH ACQUISITION CORP. | Agency | Forest Hills, NY | 5,716,218 | $1.03B |
| 37 | MAINS'L FLORIDA, INC. | Agency | Brooklyn Park, MN | 306,131 | $996.80M |
| 38 | MONTEFIORE MEDICAL CENTER | Hospital | Bronx, NY | 17,112,336 | $961.14M |
| 39 | CARING PROFESSIONALS, INC | Agency | Forest Hills, NY | 5,589,304 | $953.48M |
| 40 | PURFOODS, LLC | Ankeny, IA | 51,017,667 | $910.63M |
Brooklyn's $31.8 Billion Personal Care Industry
318 providers in one borough bill almost exclusively one code — more than the entire Medicaid spending of most states.
The Fastest-Growing Medicaid Providers in America
Which providers saw the biggest spending increases from 2023 to 2024 — and what they're billing for.
The 25 Most Expensive Medicaid Billing Codes
From personal care to ambulance rides, here's where $1.09 trillion in Medicaid spending actually goes.
The $33.9 Billion Medicaid Transportation Machine
From ambulances to taxi companies, medical transportation is one of the largest and most fraud-prone categories in Medicaid.
Which States Spend the Most Per Medicaid Beneficiary?
Alaska spends $277 per beneficiary while Illinois spends $59 — a 4.7x gap that reflects very different Medicaid programs.
Every Medicaid Provider That Has Billed Over $1 Billion
40 providers have each billed more than $1 billion in Medicaid payments between 2018 and 2024. Here's the full list.
The Company That Billed $910 Million Delivering Meals
PurFoods LLC in Ankeny, Iowa is the largest single Medicaid meal delivery provider in the country.
Excluded Providers: $350 Million in Medicaid Payments to Banned Entities
Arizona and Ohio lead the nation in Medicaid spending on OIG-excluded providers — entities banned from federal healthcare programs.
Michigan's H2015 Anomaly: 235 Claims Per Beneficiary
A cluster of Michigan providers shows extreme claims-per-beneficiary ratios on community support billing code H2015.
Who Controls 2,000 Medicaid Providers? Entity Proliferation in the NPI Registry
A handful of authorized officials control thousands of Medicaid billing entities, representing billions in spending. Some are legitimate healthcare conglomerates. The pattern itself is worth understanding.
How One Program Drives Half of New York's Medicaid Spending
$74.6 billion in personal care billing — one code, one state, one program.
T1019: The $122 Billion Billing Code
Personal care services is the single largest Medicaid billing code — and the populations it serves are among the most vulnerable.
Rural Medicaid Spending: $138.8 Billion Across 102,819 Providers
County-level analysis of Medicaid spending in rural America using USDA RUCA codes — where the money goes, what it pays for, and how rural spending differs from urban.
Rural Substance Abuse Spending Tripled in Six Years
Medicaid spending on substance abuse treatment in rural America grew from $329 million in 2018 to over $1 billion in 2023 — a 208% increase across 1,566 providers in 41 states.
The Cost of Flying Rural Medicaid Patients: $1.8 Billion in Air Transport
Air ambulance billing codes are the most disproportionately rural category in all of Medicaid — with non-emergency air transport split nearly 50/50 between rural and urban despite rural areas accounting for just 12.8% of total spending.
Public Partnerships LLC — the largest biller: a fiscal intermediary that pays self-directed home caregivers.
ModivCare Solutions — Medicaid ride broker, filed in NPPES as a "taxi."
Brooklyn, NY — one borough billed $46.5B, more than every state but five.
How the billing flags work — and why a flag is not an accusation.