The data

The whole of Medicare's billing record.

Prospect 811 runs on the data CMS publishes about who bills Medicare for what: 535 million billing, prescribing, and industry-payment records going back to 2013. Procedures, durable equipment, Part D prescriptions, hospital and post-acute case volumes, and manufacturer payments, all 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.

430M
Billing & prescribing records
~580M
Total rows including reference files
13yr
Coverage, 2013 through 2025
30
Linked CMS, HHS, FDA & other datasets
What's under the hood

Thirty datasets, linked into one picture.

The billing data tells you who's spending Medicare dollars on your codes, and the hospital files tell you where the cases happen. 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
17.6M
DME claims by provider and code, with the equipment category, the supply side of the same billing picture.
2014–2024
Hospital volumes (inpatient + outpatient)
3.4M
Facility-level case volumes: inpatient stays by MS-DRG and outpatient procedures by APC, with charges, Medicare payment, and state benchmarks. The facility side of surgical targeting.
2013–2024
Hospital service areas
10.9M
Where each hospital's Medicare inpatients actually live: stays by patient home zip, so the app can rank hospitals by who they serve, not just where they sit.
2016–2025
Post-acute utilization (SNF · home health · hospice)
874K
Facility-level Medicare utilization for every nursing home, home health agency, and hospice: patients, stays, days, and payment per year, plus wound-episode volume for home health and surgical stay mix for SNFs. The call list for wound-care and post-acute reps.
2014–2023
Medicare facility directory
122K
Every Medicare-certified facility in the country across 15 settings: SNFs, home health, hospice, ASCs (with OR counts and specialty tags), dialysis, FQHCs, and more, with star ratings, chain ownership, parent hospital-system labels, beds, and open/closed status.
2026-Q1
Open Payments (industry payments)
93.9M
Manufacturer payments to clinicians under the Sunshine Act: consulting, royalties, speaker fees, meals, research funding, and ownership stakes, by clinician and company.
2019–2025
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
Additional provider identifiers CMS publishes alongside Medicare enrollment.
Current
CLIA lab directory
302K
Every active CLIA-certified testing site in the country: name, street address, phone, certificate level, and facility type. Most never appear in billing data; that's the point: it's the whole universe of testing sites, refreshed quarterly.
Current
Patient panel summaries
13.5M
Per-provider panel profiles that show you the patients behind the billing, and find other providers whose panels look the same.
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
Lab fee schedule (CLFS)
2.2K
The national Medicare rate for every lab test, with point-of-care versions flagged. What Medicare pays, answered per code.
Reference
Physician fee schedule (MPFS)
19.4K
What Medicare actually pays for every physician procedure code, priced to your specific area rather than a national average, on every procedure page.
Current
OPPS, ASC & DMEPOS fee schedules
26.5K
National hospital-outpatient (APC) and surgery-center rates plus state-level DME fees. What the facility side of the same procedure gets paid, refreshed quarterly.
Current
FDA drug labels & NDC directory
260K
Official product reference data behind the indications, forms, and drug classes shown on every drug page.
Reference

Twenty itemized above. Ten more counted here. Thirty in total. The ten come as five groups, each with what it puts in a rep's hands:

The ten stay off the table on purpose: by the time you've copied this list, it's longer.

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, Part D, and the hospital files), 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, any prescription line with 10 or fewer claims, and any hospital cell under 11 cases, to protect patient privacy. Very low-volume activity simply won't appear, by design.

Currency

Refreshed by year

Part B, DME, Part D, and the hospital files currently run through 2024, matching what CMS has released. The lag is deliberate: CMS holds each file until every claim reaches final action, with all adjustments resolved. What you see is the settled record, not an estimate. 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 Medicare Inpatient & Outpatient Hospital files, the CMS Open Payments (Sunshine Act) files, the NPPES NPI registry, and CMS enrollment, affiliation, and drug reference data. 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 430 million billing and prescribing records at the products you sell and see what comes back.

Start prospecting
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