The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI). Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The CMS Program Statistics - Medicare Providers summary tables provide data on institutional (i.e., hospitals, skilled nursing facilities, home health agencies, hospices, etc.) and non-institutional (i.e., physicians, nonphysicians, specialists, and suppliers) providers. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR PROVIDERS 1. Medicare Providers: Number of Medicare Certified Institutional Providers, Yearly Trend MDCR PROVIDERS 2. Medicare Providers: Number of Medicare Certified Inpatient Hospital and Skilled Nursing Facility Beds and Beds Per 1,000 Enrollees, Yearly Trend MDCR PROVIDERS 3. Medicare Providers: Number of Medicare Certified Facilities, by Type of Control, Yearly Trend MDCR PROVIDERS 4. Medicare Providers: Number of Skilled Nursing Facilities and Medicare Certified Hospitals, and Number of Beds, by State, Territories, Possessions and Other Areas MDCR PROVIDERS 5. Medicare Providers: Number of Medicare Certified Providers, by Type of Provider, by State, Territories, Possessions, and Other Areas MDCR PROVIDERS 6. Medicare Providers: Number of Medicare Non-Institutional Providers by Specialty, Yearly Trend MDCR PROVIDERS 7. Medicare Providers: Number of Medicare Non-Institutional Providers, by State, Territories, Possessions, and Other Areas, Yearly Trend

Please be advised that as of Q4 2023 there is a new Provider of Service file (POS) that contains the provider and certification details for Home Health Agencies (HHAs), Hospices, and Ambulatory Surgical Centers (ASCs). Data contained in this file are extracted from the Internet Quality Improvement and Evaluation System (iQIES) environment and will be updated quarterly along with the other two POS files. The Provider of Services File - Hospital & Non-Hospital Facilities data provide critical resources for other federal regulator requirements as well as supports the ongoing quality & research efforts sponsored by CMS. In this file you will find provider certification, termination, accreditation, ownership, name, location and other characteristics organized by CMS Certification Number.

Information on Open Payments managed by the Centers for Medicare & Medicaid Services (CMS), which is a national disclosure program created by the Affordable Care Act (ACA) that promotes transparency and accountability by helping consumers understand the financial relationships between pharmaceutical and medical device industries and physicians and teaching hospitals.

Verify the accuracy of SSNs of all individual Medicare providers, owners, managing/directing employees, authorized representatives, ambulance service medical directors, ambulance crew members, technicians, chain organization administrators, Independent Diagnostic Test Facility (IDTF), supervising/directing physicians, and IDTF interpretation service providers. Also included in this Agreement are individual health care providers who apply for a National Provider Identification Number (NPI).

The Medicare Provider and Supplier Taxonomy Crosswalk dataset lists the providers and suppliers eligible to enroll in Medicare programs with the proper healthcare provider taxonomy code. This data includes the Medicare speciality codes, if available, provider/supplier type description, taxonomy code, and the taxonomy description.

The CMS Program Statistics - Medicare Physician, Non-Physician Practitioner and Supplier tables provide use and payment data for physicians, other practitioners, limited-licensed practitioners, and durable medical equipment, prosthetic, and orthotic (DMEPOS) suppliers. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR PHYSSUPP 1. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR PHYSSUPP 2. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PHYSSUPP 3. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Area of Residence MDCR PHYSSUPP 4. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Type of Service MDCR PHYSSUPP 5. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Place of Service MDCR PHYSSUPP 6. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Physician Specialty MDCR PHYSSUPP 7. Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization and Program Payments for Original Medicare Beneficiaries, by Berenson-Eggers Type of Service (BETOS) Classification

Abstract

This is a Medicare dataset released by the Center for Medicare and Medicaid Services (CMS) and accessed via BigQuery. All data is from 2014.

Documentation

For more information regarding the CMS data, click here.

From BigQuery:

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarizes the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. The dataset includes the following data - common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions.

Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.

Information on utilization and payment data for Home health agency, Hospice, skilled nursing facitlity. Information on Inpatient Prospective Payment System (IPPS) payments, Inpatient Rehabilitation Facilities (IRFs)

The All CMS Data Feeds dataset is an expansive resource offering access to 118 unique report feeds, providing in-depth insights into various aspects of the U.S. healthcare system. With over 25.8 billion rows of data meticulously collected since 2007, this dataset is invaluable for healthcare professionals, analysts, researchers, and businesses seeking to understand and analyze healthcare trends, performance metrics, and demographic shifts over time. The dataset is updated monthly, ensuring that users always have access to the most current and relevant data available.

Dataset Overview:

118 Report Feeds: - The dataset includes a wide array of report feeds, each providing unique insights into different dimensions of healthcare. These topics range from Medicare and Medicaid service metrics, patient demographics, provider information, financial data, and much more. The breadth of information ensures that users can find relevant data for nearly any healthcare-related analysis. - As CMS releases new report feeds, they are automatically added to this dataset, keeping it current and expanding its utility for users.

25.8 Billion Rows of Data:

• With over 25.8 billion rows of data, this dataset provides a comprehensive view of the U.S. healthcare system. This extensive volume of data allows for granular analysis, enabling users to uncover insights that might be missed in smaller datasets. The data is also meticulously cleaned and aligned, ensuring accuracy and ease of use.

Historical Data Since 2007: - The dataset spans from 2007 to the present, offering a rich historical perspective that is essential for tracking long-term trends and changes in healthcare delivery, policy impacts, and patient outcomes. This historical data is particularly valuable for conducting longitudinal studies and evaluating the effects of various healthcare interventions over time.

Monthly Updates:

• To ensure that users have access to the most current information, the dataset is updated monthly. These updates include new reports as well as revisions to existing data, making the dataset a continuously evolving resource that stays relevant and accurate.

Data Sourced from CMS:

• The data in this dataset is sourced directly from the Centers for Medicare & Medicaid Services (CMS). After collection, the data is meticulously cleaned and its attributes are aligned, ensuring consistency, accuracy, and ease of use for any application. Furthermore, any new updates or releases from CMS are automatically integrated into the dataset, keeping it comprehensive and current.

Use Cases:

Market Analysis:

• The dataset is ideal for market analysts who need to understand the dynamics of the healthcare industry. The extensive historical data allows for detailed segmentation and analysis, helping users identify trends, market shifts, and growth opportunities. The comprehensive nature of the data enables users to perform in-depth analyses of specific market segments, making it a valuable tool for strategic decision-making.

Healthcare Research:

• Researchers will find the All CMS Data Feeds dataset to be a robust foundation for academic and commercial research. The historical data, combined with the breadth of coverage across various healthcare metrics, supports rigorous, in-depth analysis. Researchers can explore the effects of healthcare policies, study patient outcomes, analyze provider performance, and more, all within a single, comprehensive dataset.

Performance Tracking:

• Healthcare providers and organizations can use the dataset to track performance metrics over time. By comparing data across different periods, organizations can identify areas for improvement, monitor the effectiveness of initiatives, and ensure compliance with regulatory standards. The dataset provides the detailed, reliable data needed to track and analyze key performance indicators.

Compliance and Regulatory Reporting:

• The dataset is also an essential tool for compliance officers and those involved in regulatory reporting. With detailed data on provider performance, patient outcomes, and healthcare utilization, the dataset helps organizations meet regulatory requirements, prepare for audits, and ensure adherence to best practices. The accuracy and comprehensiveness of the data make it a trusted resource for regulatory compliance.

Data Quality and Reliability:

The All CMS Data Feeds dataset is designed with a strong emphasis on data quality and reliability. Each row of data is meticulously cleaned and aligned, ensuring that it is both accurate and consistent. This attention to detail makes the dataset a trusted resource for high-stakes applications, where data quality is critical.

Integration and Usability:

Ease of Integration:

• The dataset is provided in a CSV format, which is widely compatible with most data analysis tools and platforms. This ensures that users can easily integrate the data into their existing wo...

We are releasing data that compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of May 15, 2020. This data is already available on other websites, but this chart brings the information together into one view for comparison. You can find additional information on the Accelerated and Advance Payments at the following links:

Fact Sheet: https://www.cms.gov/files/document/Accelerated-and-Advanced-Payments-Fact-Sheet.pdf;

Zip file on providers in each state: https://www.cms.gov/files/zip/accelerated-payment-provider-details-state.zip

Medicare Accelerated and Advance Payments State-by-State information and by Provider Type: https://www.cms.gov/files/document/covid-accelerated-and-advance-payments-state.pdf.

This file was assembled by HHS via CMS, HRSA and reviewed by leadership and compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of December 4, 2020.

HHS Provider Relief Fund President Trump is providing support to healthcare providers fighting the coronavirus disease 2019 (COVID-19) pandemic through the bipartisan Coronavirus Aid, Relief, & Economic Security Act and the Paycheck Protection Program and Health Care Enhancement Act, which provide a total of $175 billion for relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. HHS is distributing this Provider Relief Fund money and these payments do not need to be repaid. The Department allocated $50 billion of the Provider Relief Fund for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' net reimbursement. It allocated another $22 billion to providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers who serve low-income populations and uninsured Americans. HHS will be allocating the remaining funds in the near future.

As part of the Provider Relief Fund distribution, all providers have 45 days to attest that they meet certain criteria to keep the funding they received, including public disclosure. As of May 15, 2020, there has been a total of $34 billion in attested payments. The chart only includes those providers that have attested to the payments by that date. We will continue to update this information and add the additional providers and payments once their attestation is complete.

CMS Accelerated and Advance Payments Program On March 28, 2020, to increase cash flow to providers of services and suppliers impacted by the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. Beginning on April 26, 2020, CMS stopped accepting new applications for the Advance Payment Program, and CMS began reevaluating all pending and new applications for Accelerated Payments in light of the availability of direct payments made through HHS’s Provider Relief Fund.

Since expanding the AAP program on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals, through May 18, 2020. For Part B suppliers—including doctors, non-physician practitioners and durable medical equipment suppliers— during the same time period, CMS approved almost 24,000 applications advancing $40.4 billion in payments. The AAP program is not a grant, and providers and suppliers are required to repay the loan.

CMS has published AAP data, as required by the Continuing Appropriations and Other Extensions Act of 2021, on this website: https://www.cms.gov/files/document/covid-medicare-accelerated-and-advance-payments-program-covid-19-public-health-emergency-payment.pdf. Requests for additional data related to the program must be submitted through the CMS FOIA office. For more information on how to submit a FOIA request please visit our website at https://www.cms.gov/Regulations-and-Guidance/Legislation/FOIA. The PRF is administered by the Health Resources & Services Administration (HRSA). For more information on how to submit a request for unpublished program data from HRSA, please visit https://www.hrsa.gov/foia/index.html.

Provider Relief Fund Data - https://data.cdc.gov/Administrative/Provider-Relief-Fund-COVID-19-High-Impact-Payments/b58h-s9zx

Content

More details about each file are in the individual file descriptions.

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

This dataset is distributed under the following licenses: NA, Public Domain

The Medicare Physician & Other Practitioners by Provider and Service dataset provides information on use, payments, and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

This dataset identifies providers in Utah by their National Provider Identifier (NPI) and the specific prescriptions that were dispensed at their direction, listed by brand name (if applicable) and generic name. For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers.

The Provider of Services File (POS) - Internet Quality Improvement and Evaluation System (iQIES) - Home Health Agency (HHA), Ambulatory Surgical Center (ASC), and Hospice Providers data provides information on provider demographic and associated certification information. In this file you will find provider number (CMS Certification Number), name, address, and other characteristics of the participating institution providers.

The Medicare Home Health Agency tables provide use and payment data for home health agencies. The tables include use and expenditure data from home health Part A (Hospital Insurance) and Part B (Medical Insurance) claims.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data.

Below is the list of tables:

MDCR HHA 1. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HHA 2. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HHA 3. Medicare Home Health Agencies: Utilization and Program Payments for Original Medicare Beneficiaries, by Area of Residence MDCR HHA 4. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, Type of Agency and Type of Service Visit MDCR HHA 5. Medicare Home Health Agencies: Persons with Utilization and Total Service Visits for Original Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HHA 6. Medicare Home Health Agencies: Persons with Utilization, Total Service Visits, and Program Payments for Original Medicare Beneficiaries, by Number of Service Visits and Number of Episodes

The Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file contains data on characteristics of hospitals and other types of healthcare facilities, including the name and address of the facility and the type of Medicare services the facility provides, among other information.

The Other file contains information on non-CLIA facilities, such as hospitals, nursing facilities, home health agencies, and more (18 categories)

The CMS Program Statistics - Medicare Hospice tables provide use and payment data for hospice. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR HOSPICE 1. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR HOSPICE 2. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR HOSPICE 3. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Area of Residence MDCR HOSPICE 4. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Type of Control and Type of Service Visit MDCR HOSPICE 5. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Level of Care and Site of Service MDCR HOSPICE 6. Medicare Hospices: Utilization and Program Payments for Medicare Beneficiaries, by Number of Service Visits

The CMS Office of Enterprise Data and Analytics has developed CMS Program Statistics, which includes detailed summary statistics on national health care, Medicare populations, utilization, and expenditures, as well as counts for Medicare-certified institutional and non-institutional providers. CMS Program Statistics is organized into sections which can be downloaded and viewed separately. Tables and maps will be posted as they become finalized. CMS Program Statistics is replacing the Medicare and Medicaid Statistical Supplement, which was published annually in electronic form from 2001-2013.

CSV output from https://github.com/marks/health-insurance-marketplace-analytics/blob/master/flattener/flatten_from_index.py