About the data

The file

In February 2026 the Department of Health and Human Services published Medicaid Provider Spending, the largest Medicaid claims release it has made public: about 227 million rows covering January 2018 through December 2024. Each row is one billing provider (by NPI), one billing code, and one month, with the number of claims, the number of beneficiaries, and the dollars Medicaid paid. HHS framed the release, made with the DOGE team, as a way to let the public look for fraud.

It covers outpatient and professional claims from fee-for-service Medicaid, managed care, and CHIP. Rows with fewer than 12 claims are suppressed to protect patients.

What it leaves out

Medicaid cost about $872 billion in 2023 (CMS National Health Expenditure accounts). This file holds about $199 billion for that year — roughly 23 cents on the dollar. Missing:

• Inpatient hospital stays. A hospital's page here shows only its outpatient billing.
• Most nursing-home and other institutional care, which is billed on institutional claims.
• Prescription drugs, which HHS published as a separate file.
• Money that stays with managed-care plans. States pay plans a monthly amount per enrollee; only what plans pay out to providers shows up as claims.
• Small lines under the 12-claim suppression threshold.

The last months are also incomplete. Providers have months to file claims, and HHS cut the file before late-2024 claims were in: national payments fall from about $16 billion a month to $12.9 billion in November 2024 and $4.2 billion in December. Charts on this site hatch those two months. Treat any 2024 total as a floor.

Who the "provider" is

Every number here is keyed to the billing NPI: whoever submitted the claim and was paid. That is often not the person who did the work. The largest billers are fiscal intermediaries that pay home caregivers on a family's behalf, ride brokers, county mental-health departments and home-care agencies. Names, addresses and provider types come from the federal NPPES registry and may be out of date; the "type" shown is the provider's primary NUCC taxonomy, which providers choose themselves.

Counts and how they add up

Total paid and providers (distinct NPIs) add up the way you'd expect.

Claims and beneficiary records do not count people. HHS reports beneficiaries per provider × code × month, and we can only add those rows together. One patient seen by one provider on five codes for thirty months contributes 150 beneficiary records. We label the figure "beneficiary records" for that reason, and we don't estimate unique patients.

Plain-English code names ("Help at home with bathing, dressing and eating") are our wording for the most common codes, written from the official HCPCS and CPT descriptors, which are shown alongside.

Billing flags

Some pages carry automated "auditor's notes." They are statistical signals, not findings:

• High claims per beneficiary — more than 50 claim lines per beneficiary record, on over $500,000 paid.
• Single-code concentration — over 90% of dollars from one code, with three or fewer codes billed, on over $1 million.
• OIG exclusion — the NPI appears on the HHS Office of Inspector General's List of Excluded Individuals/Entities. Payments shown may predate the exclusion.
• Entity proliferation — the provider's authorized official is listed on more than ten billing entities.

Each has ordinary explanations. A home-care agency bills one code because it does one thing. A health system registers dozens of NPIs. Units billed per fifteen minutes produce a lot of claim lines. Use the flags to decide where to look, never as a conclusion.

The peer comparison

Provider pages rank each provider against others with the same primary type in the same state, and show the median. Size is not suspicion: a statewide agency is supposed to be hundreds of times larger than the median one.

How it's built

A single Go program serving pre-aggregated tables from a SQLite database built from the HHS file, NPPES, the NUCC taxonomy, CMS HCPCS descriptions and the OIG exclusion list. Pages are server-rendered; the charts are drawn on the server too.

Contact

Built by Patrick White. Corrections and questions: p@pwhite.org. This site is not affiliated with or endorsed by HHS, CMS, or DOGE.