{ "study": { "slug": "open-payments", "title": "The Open Payments Database, 2024", "url": "https://fonteum.com/research/open-payments", "methodology_version": "open-payments/v1" }, "data_as_of": "2026-07-14", "temporal_coverage": "2024", "sources": [ { "name": "CMS Open Payments — program year 2024", "publisher": "U.S. Centers for Medicare & Medicaid Services", "url": "https://openpaymentsdata.cms.gov/datasets", "release_date": "2026-01-23", "retrieved_at": "2026-07-14", "license": "U.S. Government Works (17 U.S.C. §105)" } ], "headline": { "program_year": 2024, "total_records": 16146544, "total_value_usd": 11955600780, "general_records": 15385047, "general_value_usd": 3313801737, "research_records": 756906, "research_value_usd": 8494017206, "ownership_records": 4591, "ownership_value_usd": 147781836, "distinct_general_npi": 979136, "distinct_general_manufacturers": 1763, "general_records_with_npi": 15336988, "teaching_hospital_records": 34391, "largest_general_payment_usd": 91082706 }, "sections": [ { "id": "by_nature", "label": "General payments by nature of payment", "columns": [ "nature_of_payment", "payments", "total_usd" ], "rows": [ { "nature_of_payment": "Royalty or License", "payments": 15053, "total_usd": 846848447 }, { "nature_of_payment": "Compensation for services other than consulting, including serving as faculty or as a speaker at a venue other than a continuing education program", "payments": 238656, "total_usd": 694537282 }, { "nature_of_payment": "Consulting Fee", "payments": 185882, "total_usd": 556511013 }, { "nature_of_payment": "Food and Beverage", "payments": 14101484, "total_usd": 411750206 }, { "nature_of_payment": "Acquisitions", "payments": 413, "total_usd": 213455947 }, { "nature_of_payment": "Travel and Lodging", "payments": 588784, "total_usd": 202500154 }, { "nature_of_payment": "Grant", "payments": 7263, "total_usd": 123006051 }, { "nature_of_payment": "Education", "payments": 151641, "total_usd": 67045121 }, { "nature_of_payment": "Honoraria", "payments": 16448, "total_usd": 43422896 }, { "nature_of_payment": "Debt forgiveness", "payments": 7687, "total_usd": 40810437 }, { "nature_of_payment": "Long term medical supply or device loan", "payments": 17141, "total_usd": 37760405 }, { "nature_of_payment": "Space rental or facility fees (teaching hospital only)", "payments": 7511, "total_usd": 33805521 }, { "nature_of_payment": "Compensation for serving as faculty or as a speaker for a medical education program", "payments": 14013, "total_usd": 32855300 }, { "nature_of_payment": "Gift", "payments": 25972, "total_usd": 4477576 }, { "nature_of_payment": "Charitable Contribution", "payments": 696, "total_usd": 4404912 }, { "nature_of_payment": "Entertainment", "payments": 6403, "total_usd": 610469 } ] }, { "id": "by_specialty", "label": "General payments by recipient specialty", "columns": [ "recipient_specialty", "payments", "total_usd" ], "rows": [ { "recipient_specialty": "Orthopaedic Surgery", "payments": 222891, "total_usd": 381416269 }, { "recipient_specialty": "Internal Medicine", "payments": 1182047, "total_usd": 113403390 }, { "recipient_specialty": "Dentist — Endodontics", "payments": 6127, "total_usd": 102330286 }, { "recipient_specialty": "Psychiatry & Neurology — Neurology", "payments": 459825, "total_usd": 89611200 }, { "recipient_specialty": "Dermatology", "payments": 521576, "total_usd": 89106518 }, { "recipient_specialty": "Neurological Surgery", "payments": 83869, "total_usd": 83073789 }, { "recipient_specialty": "Internal Medicine — Cardiovascular Disease", "payments": 452186, "total_usd": 71590219 }, { "recipient_specialty": "Internal Medicine — Hematology & Oncology", "payments": 331168, "total_usd": 68550441 }, { "recipient_specialty": "Psychiatry & Neurology — Psychiatry", "payments": 317401, "total_usd": 66292782 }, { "recipient_specialty": "Internal Medicine — Gastroenterology", "payments": 455469, "total_usd": 65513271 }, { "recipient_specialty": "Surgery", "payments": 175944, "total_usd": 65168098 }, { "recipient_specialty": "Ophthalmology", "payments": 198993, "total_usd": 60804258 }, { "recipient_specialty": "Physician Assistant", "payments": 1386673, "total_usd": 58785970 }, { "recipient_specialty": "Nurse Practitioner — Family", "payments": 1492157, "total_usd": 58448657 }, { "recipient_specialty": "Orthopaedic Surgery — Orthopaedic Surgery of the Spine", "payments": 32616, "total_usd": 54760634 }, { "recipient_specialty": "Family Medicine", "payments": 1116545, "total_usd": 51698663 }, { "recipient_specialty": "Nurse Practitioner", "payments": 1120206, "total_usd": 48749769 }, { "recipient_specialty": "Orthopaedic Surgery — Adult Reconstructive Orthopaedic Surgery", "payments": 20271, "total_usd": 47827960 }, { "recipient_specialty": "Orthopaedic Surgery — Sports Medicine", "payments": 32710, "total_usd": 47811581 }, { "recipient_specialty": "Internal Medicine — Pulmonary Disease", "payments": 201240, "total_usd": 41048225 } ] }, { "id": "by_manufacturer", "label": "General payments by reporting manufacturer", "columns": [ "manufacturer", "payments", "total_usd" ], "rows": [ { "manufacturer": "BioNTech SE", "payments": 164, "total_usd": 180558679 }, { "manufacturer": "ABBVIE INC.", "payments": 1720745, "total_usd": 156382683 }, { "manufacturer": "Stryker Corporation", "payments": 162439, "total_usd": 132155940 }, { "manufacturer": "Medtronic, Inc.", "payments": 342148, "total_usd": 117649217 }, { "manufacturer": "Arthrex, Inc.", "payments": 49443, "total_usd": 104199464 }, { "manufacturer": "Edge Endo LLC", "payments": 11, "total_usd": 91139127 }, { "manufacturer": "Zimmer Biomet Holdings, Inc.", "payments": 32760, "total_usd": 83904351 }, { "manufacturer": "INTUITIVE SURGICAL, INC.", "payments": 116855, "total_usd": 72225869 }, { "manufacturer": "Takeda Pharmaceuticals U.S.A., Inc.", "payments": 171595, "total_usd": 71616187 }, { "manufacturer": "Advanced Accelerator Applications", "payments": 167, "total_usd": 63931988 }, { "manufacturer": "AstraZeneca Pharmaceuticals LP", "payments": 609976, "total_usd": 63099382 }, { "manufacturer": "Boston Scientific Corporation", "payments": 265585, "total_usd": 61435976 }, { "manufacturer": "Genentech, Inc.", "payments": 2534, "total_usd": 59226516 }, { "manufacturer": "GENZYME CORPORATION", "payments": 181575, "total_usd": 55555371 }, { "manufacturer": "DePuy Synthes Products, Inc.", "payments": 2541, "total_usd": 50211032 }, { "manufacturer": "Smith+Nephew, Inc.", "payments": 71394, "total_usd": 46443943 }, { "manufacturer": "Amgen Inc.", "payments": 473135, "total_usd": 44726300 }, { "manufacturer": "Lilly USA, LLC", "payments": 534793, "total_usd": 43147651 }, { "manufacturer": "PFIZER INC.", "payments": 568278, "total_usd": 42509659 }, { "manufacturer": "Abbott Laboratories", "payments": 291957, "total_usd": 38150794 } ] }, { "id": "by_state", "label": "General payments by recipient state", "columns": [ "state", "payments", "total_usd" ], "rows": [ { "state": "CA", "payments": 1370072, "total_usd": 334476958 }, { "state": "FL", "payments": 1347271, "total_usd": 304725698 }, { "state": "PA", "payments": 665965, "total_usd": 303312778 }, { "state": "MA", "payments": 218332, "total_usd": 225083292 }, { "state": "TX", "payments": 1445102, "total_usd": 221196400 }, { "state": "NY", "payments": 1032846, "total_usd": 211935025 }, { "state": "MO", "payments": 326555, "total_usd": 120120501 }, { "state": "IL", "payments": 523046, "total_usd": 117988401 }, { "state": "OH", "payments": 602937, "total_usd": 109250204 }, { "state": "MI", "payments": 474631, "total_usd": 100175692 }, { "state": "NC", "payments": 534809, "total_usd": 95684664 }, { "state": "TN", "payments": 499805, "total_usd": 81169175 }, { "state": "VA", "payments": 376984, "total_usd": 79405040 }, { "state": "GA", "payments": 591583, "total_usd": 77991751 }, { "state": "AZ", "payments": 365101, "total_usd": 66886433 }, { "state": "NJ", "payments": 515946, "total_usd": 63945797 }, { "state": "CO", "payments": 204162, "total_usd": 62697684 }, { "state": "WA", "payments": 146685, "total_usd": 57113093 }, { "state": "MD", "payments": 299225, "total_usd": 53180978 }, { "state": "MN", "payments": 65107, "total_usd": 49353906 }, { "state": "IN", "payments": 351015, "total_usd": 48578701 }, { "state": "AL", "payments": 332021, "total_usd": 35847662 }, { "state": "SC", "payments": 312954, "total_usd": 34777907 }, { "state": "CT", "payments": 206551, "total_usd": 34615281 }, { "state": "KY", "payments": 322221, "total_usd": 34539336 }, { "state": "UT", "payments": 127178, "total_usd": 34205537 }, { "state": "KS", "payments": 147605, "total_usd": 33317001 }, { "state": "LA", "payments": 322913, "total_usd": 33052139 }, { "state": "HI", "payments": 52164, "total_usd": 32826576 }, { "state": "WI", "payments": 96785, "total_usd": 30326867 }, { "state": "NV", "payments": 151044, "total_usd": 27406281 }, { "state": "DC", "payments": 46139, "total_usd": 25483282 }, { "state": "OK", "payments": 198830, "total_usd": 23958240 }, { "state": "OR", "payments": 75459, "total_usd": 19486663 }, { "state": "IA", "payments": 85805, "total_usd": 17407427 }, { "state": "MS", "payments": 183017, "total_usd": 15040562 }, { "state": "AR", "payments": 152334, "total_usd": 13051824 }, { "state": "ID", "payments": 62741, "total_usd": 12118307 }, { "state": "NH", "payments": 34331, "total_usd": 9222536 }, { "state": "NE", "payments": 97530, "total_usd": 9169101 }, { "state": "WV", "payments": 97032, "total_usd": 8129304 }, { "state": "PR", "payments": 58036, "total_usd": 7379567 }, { "state": "SD", "payments": 28532, "total_usd": 7237661 }, { "state": "RI", "payments": 47753, "total_usd": 7132384 }, { "state": "NM", "payments": 48679, "total_usd": 6668924 }, { "state": "DE", "payments": 50181, "total_usd": 4203386 }, { "state": "ME", "payments": 19220, "total_usd": 3404219 }, { "state": "MT", "payments": 19552, "total_usd": 2619332 }, { "state": "ND", "payments": 19486, "total_usd": 1744999 }, { "state": "WY", "payments": 10422, "total_usd": 1571159 }, { "state": "AK", "payments": 17008, "total_usd": 1543006 }, { "state": "VT", "payments": 2487, "total_usd": 1414644 }, { "state": "AE", "payments": 534, "total_usd": 96489 }, { "state": "AP", "payments": 382, "total_usd": 73121 }, { "state": "VI", "payments": 106, "total_usd": 17749 }, { "state": "GU", "payments": 335, "total_usd": 13096 }, { "state": "AS", "payments": 10, "total_usd": 732 }, { "state": "MP", "payments": 24, "total_usd": 659 }, { "state": "AA", "payments": 3, "total_usd": 165 } ] }, { "id": "largest_general", "label": "Largest single general payments", "columns": [ "rank", "amount_usd", "nature_of_payment", "manufacturer", "recipient_specialty", "state" ], "rows": [ { "rank": 1, "amount_usd": 91082706, "nature_of_payment": "Acquisitions", "manufacturer": "Edge Endo LLC", "recipient_specialty": "Dentist — Endodontics", "state": "FL" }, { "rank": 2, "amount_usd": 88596339, "nature_of_payment": "Royalty or License", "manufacturer": "BioNTech SE", "recipient_specialty": null, "state": "PA" }, { "rank": 3, "amount_usd": 53413600, "nature_of_payment": "Royalty or License", "manufacturer": "BioNTech SE", "recipient_specialty": null, "state": "PA" }, { "rank": 4, "amount_usd": 28269974, "nature_of_payment": "Royalty or License", "manufacturer": "BioNTech SE", "recipient_specialty": null, "state": "PA" }, { "rank": 5, "amount_usd": 26745896, "nature_of_payment": "Acquisitions", "manufacturer": "Henry Schein, Inc.", "recipient_specialty": "Orthopaedic Surgery", "state": "HI" }, { "rank": 6, "amount_usd": 25000000, "nature_of_payment": "Acquisitions", "manufacturer": "Zimmer Biomet Holdings, Inc.", "recipient_specialty": "Orthopaedic Surgery", "state": "VA" }, { "rank": 7, "amount_usd": 16066655, "nature_of_payment": "Royalty or License", "manufacturer": "Takeda Pharmaceuticals U.S.A., Inc.", "recipient_specialty": null, "state": "MA" }, { "rank": 8, "amount_usd": 13180782, "nature_of_payment": "Royalty or License", "manufacturer": "Genentech, Inc.", "recipient_specialty": null, "state": "MA" }, { "rank": 9, "amount_usd": 12477310, "nature_of_payment": "Royalty or License", "manufacturer": "Genentech, Inc.", "recipient_specialty": null, "state": "MA" }, { "rank": 10, "amount_usd": 12070094, "nature_of_payment": "Royalty or License", "manufacturer": "Genentech, Inc.", "recipient_specialty": null, "state": "MA" } ] } ], "limitations": [ "A disclosed payment is not misconduct. Open Payments documents legal, routine financial relationships; these totals describe transparency, not wrongdoing.", "One program year. All figures are CMS program year 2024 and are a snapshot of one year, not a trend.", "Manufacturer-reported. Companies report the data and CMS publishes it after a dispute window. Disputed records are included as reported; a small share of records carry no NPI and a few amounts are corrected in later releases.", "Records, not people. Category and specialty totals count payment records. One clinician can appear in many records; the general file is not de-duplicated to a per-physician total.", "Research flows to institutions. The research total largely funds study sites, not individual clinicians, and is kept out of the per-clinician framing.", "Aggregate-only, no quality claim. Fonteum does not name, rank, or rate any clinician here, and industry payments are not a measure of a provider's competence or the quality of care." ], "reproducible_sql": "-- Headline: records + dollars by file\nSELECT record_type,\n count(*) AS records,\n round(sum(total_amount_usd)) AS total_usd\nFROM cms_open_payments\nWHERE program_year = 2024\nGROUP BY record_type;\n\n-- General payments by nature of payment\nSELECT nature_of_payment,\n count(*) AS payments,\n round(sum(total_amount_usd)) AS total_usd\nFROM cms_open_payments\nWHERE record_type = 'general' AND program_year = 2024\nGROUP BY nature_of_payment\nORDER BY total_usd DESC;\n\n-- General payments by recipient specialty (top 20)\nSELECT recipient_specialty,\n count(*) AS payments,\n round(sum(total_amount_usd)) AS total_usd\nFROM cms_open_payments\nWHERE record_type = 'general' AND program_year = 2024\n AND recipient_specialty IS NOT NULL\nGROUP BY recipient_specialty\nORDER BY total_usd DESC\nLIMIT 20;\n\n-- Distinct recipients + reporting manufacturers (general)\nSELECT count(DISTINCT recipient_npi) AS distinct_clinicians,\n count(DISTINCT manufacturer_name) AS reporting_manufacturers\nFROM cms_open_payments\nWHERE record_type = 'general' AND program_year = 2024;", "license": "U.S. Government Works (17 U.S.C. §105)", "generated_by": "Fonteum — https://fonteum.com", "notes": "Aggregate, source-traced figures frozen to the as-of date above. Re-derive by running the published query against the named source file; no per-person records are included." }