Top 10 US States by Total Open Payments Disclosure Volume
PlainPharmaWatch ranks US states by total dollar volume of payments disclosed under the Sunshine Act, summing across all reporting entities, payment categories, and recipient types. Rendered live from the states table.
Ranked by absolute payment total, not normalized for population; states with more physicians and more academic medical centers naturally accumulate higher totals. This is not a proxy for state-level clinical practice quality, prescribing behavior, or healthcare system integrity. Full caveats below.
Research period:
Research question
Across the 62 US states and territories represented in the CMS Open Payments database, which received the largest aggregate disclosure volume in the most recent program year, and how do state totals reflect the underlying density of US physicians, teaching hospitals, and academic medical centers?
Methodology
This ranking reflects the data currently in our database, sourced from the agency referenced in the citation below and updated automatically as new filings are processed.
Coverage and exclusions: the source agency occasionally suppresses values for confidentiality, small sample size, or quality control, and suppressed rows are excluded from this ranking rather than shown as zero. If the agency later revises a figure, the revised value replaces the old one automatically the next time our data is refreshed.
Data provenance: we pull each release as it becomes available and normalize it into our database; a later release simply supersedes the one before it, so readers never see a mix of old and new figures on the same page.
Comparability across years: when the source agency revises its release schedule, definitions, or coverage, we note the affected years on the methodology page so readers can compare like-with-like rather than across a changed measurement.
Editorial governance: a named editor reviews every ranking page before publication (see the byline above). If an entity disputes a figure attributed to it, corrections are checked against the official source record before any change is made.
Every number on this page can be traced back to its source by following the entity links and the citation below, so independent verification never requires anything beyond the original public source.
See the methodology page for the complete ETL pipeline, source vintage, and column lineage.
Top 10 US States by Total Open Payments Disclosure Volume
Live data: reflects the current dataset
The ranked top 10
Every row below reflects the current 10-record dataset. Reload the page after new data is processed to see the latest values.
| # | State | Total payments | Physician recipients | Hospital recipients |
|---|---|---|---|---|
| 1 | California | $342M | 75,013 | 121 |
| 2 | Florida | $335M | 54,303 | 76 |
| 3 | Pennsylvania | $305M | 31,976 | 72 |
| 4 | Massachusetts | $230M | 16,112 | 37 |
| 5 | Texas | $225M | 58,838 | 87 |
| 6 | New York | $217M | 49,928 | 104 |
| 7 | Missouri | $122M | 14,854 | 26 |
| 8 | Illinois | $120M | 29,359 | 60 |
| 9 | Ohio | $112M | 27,813 | 69 |
| 10 | Georgia | $107M | 22,488 | 29 |
Source: Centers for Medicare & Medicaid Services, CMS Open Payments, State-level disclosure aggregates. Values reflect the current dataset, refreshed as new filings are processed. Centers for Medicare & Medicaid Services, CMS Open Payments, State-level disclosure aggregates. Values reflect the current dataset, refreshed as new filings are processed.
Findings
Top entity in the ranking
The top-ranked record in this dataset is California, with a value of $342M on the Total payments column. The full top-10 set is rendered in the table above. Every value comes directly from the current dataset; no number is hardcoded into this page. When the source agency publishes a revision, the ranking and the prose around it update automatically.
Distribution shape
The gap between the top-ranked record ($342M) and the 10th-ranked record ($107M) characterizes how concentrated the top of the distribution is. Where the top value is many multiples of the median value of the visible set, the population is highly concentrated, a small number of entities accumulate the bulk of the measured quantity. Where the top and bottom of the visible set are close together, the distribution is relatively flat across the top end. The full distribution beyond this top-10 cut is summarized in the aggregate context section below and explored in the linked entity profiles.
Aggregate context
Across the full population behind this ranking, here are the summary statistics: how many records exist in total, the sum of the ranking metric across all qualifying records, and the mean per-record value. The methodology page documents the exact filter applied (records with null or zero values on the ranking metric are excluded). This aggregate row is computed from the same dataset that powers the ranking above.
Source provenance
The records in this ranking originate from Centers for Medicare & Medicaid Services, specifically the CMS Open Payments, State-level disclosure aggregates. PlainPharmaWatch ingests the source vintage published by the agency and keeps this page current, there is no static export carrying stale numbers, and a newly published dataset is reflected here within hours. The methodology page documents the source URL, the vintage date, and the steps applied to prepare the data.
Why this ranking matters
Rankings like this one let a reader scan a population quickly and identify outliers, concentrations, and patterns that warrant deeper investigation. The detail pages linked from each entity in the table above give the full per-entity context: time-series history where available, related metrics from adjacent tables, and links onward to the underlying source records. The methodology page explains how an entity earns inclusion in the dataset and how the ranking column is computed at the source.
What this analysis cannot tell us
State totals reflect the recipient's primary practice address as recorded in the CMS Open Payments submission. Physician practice addresses may differ from residence, billing, or licensure state, particularly for telehealth practices and academic affiliates with multi-state appointments. States with concentrated academic medical-center clusters (research-grant payments) or pharmaceutical-industry corporate hubs naturally accumulate larger totals; this ranking should not be read as a proxy for state-level clinical practice quality, prescribing behavior, or healthcare system integrity. Royalty-and-license payments concentrate disproportionately in states with universities and research institutions where employee-inventors are based. Population is not normalized in this ranking; large-population states naturally accumulate larger absolute totals. CMS publishes the data without state-population normalization and we follow the agency's convention.
Secondary cut from the same source
Top 10 states by count of physician recipients (a coarse proxy for in-state physician density)
Sources
- CMS Open Payments, Public Disclosure Database - https://openpaymentsdata.cms.gov/
- CMS Open Payments, Methodology and Data Dictionary - https://www.cms.gov/openpayments/about/resources
Every figure on PlainPharmaWatch is rendered directly from federal source data, no number is typed in by an editor. This page draws directly on federal source data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.