Every number on OpenMedicare comes from publicly available government data. Here's exactly where it comes from, how fresh it is, and what it contains. See our methodology for how we process and analyze this data.
Transparency commitment: We only use publicly available government data. No proprietary datasets, no purchased records, no scraped patient information. Anyone can verify our analysis using the same sources listed below.
Centers for Medicare & Medicaid Services (CMS)
The primary dataset powering OpenMedicare. Contains every Medicare Part B claim at the provider-service level, including services rendered, beneficiaries served, submitted charges, allowed amounts, and Medicare payments.
2014–2023
~96 million rows (all years combined)
Updated annually by CMS, typically with a 2-year lag. Most recent data: Calendar year 2023.
December 2024
Department of Health & Human Services, Office of Inspector General
Database of individuals and entities excluded from all federal healthcare programs due to convictions for fraud, patient abuse, licensing violations, or other misconduct. We cross-reference this with active Medicare billing data to identify providers who may still be practicing.
1977–present
~78,000 excluded individuals/entities
Updated monthly by OIG.
January 2025
U.S. Department of Justice
Public records of federal healthcare fraud prosecutions, settlements, and convictions. Used to validate our fraud detection model against confirmed cases and to provide context for flagged providers.
2010–present
~2,500 cases referenced
Cases added as they are publicly announced.
Ongoing
Centers for Medicare & Medicaid Services
Supplementary enrollment data used to verify provider credentials, practice locations, and enrollment status. Helps identify providers billing from unusual locations or with irregular enrollment patterns.
Current snapshot
~2.1 million enrolled providers
Updated quarterly.
Q4 2024
Centers for Medicare & Medicaid Services
The National Plan and Provider Enumeration System registry containing all assigned NPIs. Used to resolve provider identities, verify credentials, and link records across datasets.
Current
~7.8 million NPIs assigned
Updated daily.
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