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Claims & Spending

CMS Medicaid Provider Spending

Provider-level Medicaid spending with NPI enrichment — 227M+ claims, 50+ states, 2018-present.

227M+ Medicaid claims, 50+ states

Monthly, as CMS publishes

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About this product

The CMS Medicaid Provider Spending Dataset delivers 227M+ outpatient Medicaid claims aggregated by provider, procedure, and month across 50+ states — automatically updated when CMS publishes new T-MSIS (Transformed Medicaid Statistical Information System) data. This analytics-ready product enriches spending records with NPI provider demographics from NPPES and state-level data quality ratings from the CMS DQ Atlas, so you know which states to trust before you query.

With several states flagged unusable and many more rated high concern by CMS, the built-in quality scoring saves analysts weeks of cross-referencing. Designed for health-policy analysts, Medicaid program administrators, and healthcare consultants who need provider-level Medicaid expenditure intelligence without months of data wrangling.

Questions it answers

  • Which providers are billing outliers by service code and state?

  • How did Medicaid spending shift through the pandemic and after?

  • Which states' T-MSIS data is reliable enough to include in my analysis?

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dataplex

Analysis-ready public data products for healthcare, delivered on the platform you already use.

© 2026 Dataplex Consulting & Data Products

dataplex

Analysis-ready public data products for healthcare, delivered on the platform you already use.

© 2026 Dataplex Consulting & Data Products

dataplex

Analysis-ready public data products for healthcare, delivered on the platform you already use.

© 2026 Dataplex Consulting & Data Products