The data

The whole of Medicare's billing record.

Prospect 811 runs on the data CMS publishes about who bills Medicare for what — 427 million billing and prescribing records going back to 2013 — procedures, durable equipment, and Part D prescriptions — stitched together with the provider registry, group affiliations, enrollment files, patient-panel summaries, and FDA drug labels. Public data, all of it, in one place you can actually search.

427M
Billing & prescribing records
~470M
Total rows across the warehouse
12yr
Coverage, 2013 through 2024
12
Linked CMS, HHS & FDA datasets
What's under the hood

Twelve datasets, linked by NPI.

The billing data tells you who's spending Medicare dollars on your codes. The rest tells you who they are, where they are, and who they're part of.

DatasetRowsWhat it gives youYears
Medicare Part B billing
107M
Every provider's billing by HCPCS code — services rendered, charges submitted, and what Medicare allowed and paid.
2014–2024
Medicare Part D prescriptions
304M
Every prescriber's drug-level claims — brand and generic, claim counts, and cost. The pharma side of the same picture.
2013–2024
Durable Medical Equipment
16.3M
DME claims by provider and code, with the equipment category — the supply side of the same billing picture.
2014–2023
Provider affiliations
17.8M
Which clinicians roll up to which groups and practices, so an individual NPI connects to the whole organization.
Current
NPI registry (NPPES)
9.5M
The provider directory — names, credentials, specialty, practice address, and the phone number behind click-to-call.
Current
Medicare enrollment (PECOS)
2.98M
Enrollment records that confirm who's actively participating in Medicare.
Current
State Medicaid IDs
1.4M
Cross-reference identifiers that tie providers across state Medicaid programs.
Current
Patient panel summaries
13.5M
Per-provider panel profiles: average risk score, age, dual-eligible share, and chronic-condition rates — the fuel behind panel intel and lookalikes.
2013–2024
Specialty taxonomy
879
The lookup that turns taxonomy codes into the specialty labels you filter and search by.
Reference
ASP drug pricing
Average Sales Price limits for drugs, for context on what's reimbursable.
Reference
FDA drug labels & NDC directory
260K
Official product labels and identifiers — the source of the indications, forms, and drug classes shown on every drug page.
Reference
Scale

Most of the weight is in the billing data.

Part D prescriptions are the biggest single file — three hundred million rows on their own, with Part B right behind. Everything else exists to give those numbers a name and a place.

The granularity

Down to a single billing line.

Every row is one provider, one code or drug, one year — with the dollars attached. This is what a search is actually reading.

Because the data goes this deep, a search can do more than name a provider. It can rank them by exactly the codes you sell, compare what they bill year over year, and roll it up to the group they belong to.

  • Search by NPI, code, drug, or zip
  • Rank by services or Medicare dollars
  • Filter by specialty, city, and state
  • Join billing to names, phones, and affiliations
Straight about it

What the data is — and isn't.

It's a powerful picture, but it's a specific one. Knowing the edges makes you sharper with it.

Scope

Medicare fee-for-service

This is traditional Medicare — Part B, DME, and Part D — not commercial insurance or Medicare Advantage. For providers who serve Medicare patients, it's the clearest billing signal there is.

Suppression

The under-11 rule

CMS withholds any provider-and-code line with fewer than 11 beneficiaries, and any prescription line with 10 or fewer claims, to protect patient privacy. Very low-volume activity simply won't appear — by design.

Currency

Refreshed by year

Part B and Part D currently run through 2024 and DME through 2023, matching what CMS has released. New years load in as CMS publishes them.

Where it comes from

Public data, sourced straight.

Built entirely from public CMS and HHS releases — Medicare Provider Utilization & Payment data (Part B, DME, and Part D prescriber files), the NPPES NPI registry, provider affiliation files, Medicare enrollment data, and openFDA drug labels. Prospect 811 organizes and connects these sources; it doesn't add to or alter the underlying numbers. Not affiliated with or endorsed by CMS.

Search all of it on your own codes.

Point four hundred million billing records at the products you sell and see what comes back.

Start prospecting
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