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OpenMedicare

Independent Medicare data journalism

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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending · OpenImmigration · OpenCrime · OpenLobby · VaccineWatch · WarCosts · OpenPrescriber · GiveScope · SPACGraveyard · AI Exposure · TariffTax · ShelterScope · PermitCore · TheDataProject.ai

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Methodology•Download Data

New to OpenMedicare?

Here's where to start.

👋
Step 1

Welcome — The Big Picture

OpenMedicare analyzes 1.82 million providers across $940B in Medicare payments, with 30,000+ deep-profiled. 500 are ML-flagged for fraud risk.

🔍
Step 2

Check Your Doctor

Search any of 1.7M Medicare providers — 30,000+ have detailed profiles with billing history, specialty comparison, and risk flags.

🚨
Step 3

Explore the Fraud Analysis

We flagged 500 providers with statistical billing anomalies. See who's billing impossible volumes.

🤖
Step 4

Still Out There

Our AI model trained on 2,198 confirmed fraudsters found 500 providers who bill like criminals but haven't been caught. AUC: 0.83.

📰
Step 5

Read Our Investigations

68 data-driven investigations exploring Medicare spending patterns, from drug money to geographic inequality.

📊
Step 6

Dive Into the Data

State-by-state breakdowns, specialty comparisons, 10-year trends, and more.

Step 7: Interactive Tools

Hands-on ways to explore the data yourself.

⚖️
Compare Providers
🧮
Cost Calculator
💵
Your Medicare Dollar

Step 8: Browse the Data

Jump directly into provider, state, specialty, or procedure data.

👨‍⚕️
Providers
📍
States
🩺
Specialties
📋
Procedures
$940B+
Total Payments
1.82M
Providers
11 Years
of Data (2014-2024)
500
AI-Flagged Providers

About the Data

Every number on OpenMedicare comes from official CMS data — the Centers for Medicare & Medicaid Services Medicare Provider Utilization and Payment Data. This covers every payment Medicare Part B made to every physician and supplier in the United States from 2014 through 2024.

We process over 96 million rows of billing data to calculate provider-level statistics, specialty comparisons, geographic patterns, and trend analysis. Our AI fraud detection model was trained on the billing patterns of 2,198 confirmed Medicare fraudsters to identify active providers with similar patterns.

This data is public and free. We didn't create it — we made it accessible, searchable, and understandable. CMS publishes this data annually. We clean it, analyze it, and present it in a way that anyone can explore.

What You'll Find on OpenMedicare

💰 $940B+ in Payments

Every dollar Medicare Part B has paid to every provider from 2014 through 2024 — fully searchable and analyzed. See where your tax dollars and premiums actually go.

🤖 AI Fraud Detection

Our machine learning model, trained on 2,198 confirmed fraudsters, has flagged 500 active providers with suspicious billing patterns. Each comes with a detailed risk profile.

📰 74+ Investigations

Data-driven investigations into Medicare fraud schemes, spending patterns, geographic inequality, and the stories behind the numbers.

📊 Interactive Analysis

Drug spending trends, markup ratios, rural vs urban breakdowns, state-by-state comparisons, and 11-year trend lines — all interactive.

Common Questions

Is this data real?

Yes. Every number comes from official CMS (Centers for Medicare & Medicaid Services) public datasets. We process, analyze, and present the data — we don't create it.

Does a high-risk AI flag mean a provider is committing fraud?

No. Our AI identifies statistical patterns that resemble known fraud. It's a signal for further review, not a determination of guilt. Many flagged providers may have legitimate reasons for unusual billing.

How current is the data?

Our dataset covers 2014-2024 (11 years). CMS releases data with approximately a 1-2 year lag. The most recent complete year in our dataset is 2024.

Why does this matter?

Medicare spends $890B+ annually serving 68.5 million Americans. Fraud wastes an estimated $60-100 billion per year. Transparency — knowing where the money goes and who's getting it — is the first step toward accountability.

Tips for Exploring

🔍 Search by NPI Number

Every Medicare provider has a unique 10-digit NPI (National Provider Identifier). If you have it, searching by NPI gives you the most precise results. You can find NPIs on medical bills, insurance statements, or the CMS NPPES registry.

📊 Understand the Numbers

Payment amounts show what Medicare actually paid, not what was charged. Providers typically charge 3-4x more than Medicare pays. High payments don't necessarily mean a provider is expensive — it often means they see many Medicare patients.

🚨 About Fraud Flags

AI fraud flags are statistical indicators, not accusations. A flagged provider may have perfectly legitimate reasons for unusual billing patterns (e.g., specialized practice, high-volume clinic). Always consider context before drawing conclusions.

🗺️ State-Level Detail

Each of our 61 state/territory pages includes top providers, specialty breakdowns, spending trends, and fraud flags specific to that location. Great for understanding Medicare in your area.

Why OpenMedicare Exists

Medicare is the largest healthcare payer in the United States, spending over $890 billion annually to serve 68.5 million Americans. That's public money — funded by payroll taxes, premiums, and general revenue. Every taxpayer has a stake in how it's spent.

Yet most Americans have no idea where their Medicare dollars go. Which providers receive the most? Which procedures cost the most? Who's billing suspiciously? CMS publishes this data, but it's buried in massive CSV files that require technical expertise to access.

OpenMedicare makes this data accessible to everyone. Search any provider. Compare costs. Explore spending patterns. Read investigations. The goal is simple: transparency breeds accountability.

Have a tip? Know about suspicious billing?

Report Fraud

All data sourced from Centers for Medicare & Medicaid Services (CMS)

Medicare Provider Utilization and Payment Data, 2014-2024

About OpenMedicare · Updates & Changelog · 74+ Investigations