Follow the Money

Open Payments is the federal transparency program created by the Physician Payments Sunshine Act. Every pharmaceutical and medical-device manufacturer must report what they paid to US doctors, and CMS publishes the file. In program year 2024, just 10 companies account for 35.5% of all industry-to-physician dollars, and three payment categories (consulting, royalty, acquisitions) carry 47.1% of the money on 1.28% of the records. This page turns 14.3M records into patterns you can scan.

Top 15 companies by total dollars paid to US doctors, 2024.

AbbVie leads the 2024 file at $150.3M paid to 226,167 doctors, with BOTOX as the top-named product. Stryker follows at $113.3M to 28,695 recipients, then Medtronic at $112.9M tied to its CD HORIZON spinal system. The ranked top 20 captures the bulk of industry-to-physician dollar flow in the country. Concentration is a feature of this dataset, not an anomaly.

The top 10 companies combined paid $869M, or 35.5% of every industry-to-physician dollar in 2024. That concentration reflects who writes the biggest checks: a handful of large pharma and orthopedic-device manufacturers. Click any company for per-state breakdowns and the full top-recipient table.

Payment types ranked by total dollars. Record count tells a different story than dollars.

Food and Beverage is the most common payment type by a wide margin: 13.2M records at an average of $29 per meal. But meals do not lead the dollar column. Speaking and faculty compensation tops total spend at $537.8M, followed by Consulting at $498.8M and Royalty or License at $447.8M. Royalty has only 10,563 records in the whole year, but averages $42,397 per payment, with one royalty check reaching $9.15M.

Consulting, royalty, and acquisitions combined reach $1.16B, which is 47.1% of all dollars on just 1.28% of records. That is the premium tier. The Food and Beverage column is where the reach sits, since most of the 948,323 paid doctors touch the program through a meal. The premium tier is where the real money sits.

Six patterns from 14.3 million payment records. Each number traces to Open Payments.

Top 12 specialties by total dollars received. Per-doctor rate shown alongside.

Orthopaedic Surgery leads total dollars at $363.7M across 17,012 doctors, or $21,382 per doctor, driven by device royalties and consulting contracts on joints, spine implants, and instruments. But the per-doctor leader is a dental specialty: 1,770 endodontists received $102.2M, or $57,719 each. Total dollars and per-doctor dollars tell different stories.

Device-heavy specialties (orthopedic surgery, neurological surgery, cardiology) draw royalty and consulting dollars from implant manufacturers. Primary-care specialties draw high-volume, low-dollar meals and education: Internal Medicine averages $978 per doctor and Family nurse practitioners average $538. Orthopaedic Surgery's $21,382 per doctor runs roughly 22x what internal medicine pulls per head.

Top 10 states by total dollars paid to doctors in the state.

Florida leads all states at $277.6M paid to 81,972 doctors, edging California at $271.4M to 93,842 doctors. Per doctor, Florida runs $3,386 against California's $2,892. The biggest total is not always the biggest per-doctor rate.

Per-doctor differences reflect specialty mix. Florida's concentration of orthopedic surgeons, sports-medicine clinics, and dental specialists pulls its average up. Texas is the third-biggest pot at $188.5M but runs at just $2,243 per doctor across a much broader base.

Individual doctors receiving the largest payment totals in 2024. Open Payments requires disclosure by name.

Charles Goodis, an endodontist in Florida, received $91,082,706 in a single payment in 2024, making him the country's #1 recipient. Robert Medoff, an orthopedic surgeon in Hawaii, is second at $26.7M, also from a single payment. These are public records. The Sunshine Act requires full transparency, including names. The distribution is a tiny peak, not a broad tail.

The top 10 doctors combined captured $227M, or 9.3% of all industry-to-physician dollars. Royalty and acquisition deals on patented devices concentrate money on a small group of inventors, not on general clinicians.

Search 1557 reporting companies, or scroll the ranked list. Click any company for state breakdown, top recipients, and product detail.

What Open Payments is, and why these numbers exist.

How this page was built and what it includes.