Data sources
Data sources
All figures come from public files published by the Centers for Medicare & Medicaid Services (CMS), processed with the scripted build described below.
CMS Federal IDR public use files
Published on the CMS page “Independent dispute resolution reports”: https://www.cms.gov/nosurprises/policies-and-resources/reports. We use the “OON Emergency & Non-Emergency” file of each quarterly PUF, together with the CMS Federal IDR PUF data dictionary for field definitions.
| Quarter | File used (OON Emergency & Non-Emergency) | Format | Line items | Vintage noted in file name |
|---|---|---|---|---|
| 2023 Q1 | 2023Q1_oon_ene.csv | Excel workbook (converted to CSV) | 65,271 | February 15, 2024 release |
| 2023 Q2 | 2023Q2_oon_ene.csv | Excel workbook (converted to CSV) | 113,121 | |
| 2023 Q3 | 2023Q3_oon_ene.csv | Excel workbook (converted to CSV) | 76,540 | |
| 2023 Q4 | 2023Q4_oon_ene.csv | Excel workbook (converted to CSV) | 78,438 | |
| 2024 Q1 | 2024Q1_oon_ene.csv | Excel workbook (converted to CSV) | 186,533 | March 18, 2025 re-release |
| 2024 Q2 | 2024Q2_oon_ene.csv | Excel workbook (converted to CSV) | 377,786 | |
| 2024 Q3 | 2024Q3_oon_ene.csv | Excel workbook (converted to CSV) | 660,860 | |
| 2024 Q4 | 2024Q4_oon_ene.csv | Excel workbook (converted to CSV) | 947,215 | |
| 2025 Q1 | Federal IDR PUF for 2025 Q1 - OON Emergency & Non-Emergency (As of January 21, 2026).csv | CSV | 1,114,674 | as of January 21, 2026 |
| 2025 Q2 | Federal IDR PUF for 2025 Q2 - OON Emergency & Non-Emergency (As of January 21, 2026).csv | CSV | 1,632,680 | as of January 21, 2026 |
| 2025 Q3 | federal-idr-puf-2025-q3-oon-emergency-&-non-emergency.csv | CSV | 1,573,101 | |
| 2025 Q4 | federal-idr-puf-2025-q4-oon-emergency-&-non-emergency.csv | CSV | 1,407,684 |
2023–2024 rows are read from CSV conversions of the “OON Emergency and Non-Emergency” worksheet of each workbook. 2025 Q3–Q4 are the CMS CSV files as downloaded; CMS’s reports page currently lists 2025 Q3–Q4 files dated July 22, 2026, and we have not confirmed that our copies match that date. Total: 8,233,903 line items.
CMS “QPA and Offers” files (dollar amounts)
Dollar amounts use the “QPA and Offers” file of the same quarterly PUFs, 2024 Q3 to 2025 Q4 only (see methodology). 2024 Q3–Q4 are read from CSV conversions of the “QPA and Offers” worksheet; 2025 quarters are the CMS CSV files.
| Quarter | File used (QPA and Offers) | Rows | Air ambulance rows removed | Line items with dollar amounts |
|---|---|---|---|---|
| 2024 Q3 | 2024Q3_qpa_offers.csv | 670,964 | 10,102 | 510,545 |
| 2024 Q4 | 2024Q4_qpa_offers.csv | 960,750 | 13,535 | 717,415 |
| 2025 Q1 | Federal IDR PUF for 2025 Q1 - QPA and Offers (As of January 21, 2026).csv | 1,128,072 | 13,400 | 877,432 |
| 2025 Q2 | Federal IDR PUF for 2025 Q2 - QPA and Offers (As of January 21, 2026).csv | 1,647,029 | 14,349 | 1,226,093 |
| 2025 Q3 | federal-idr-puf-2025-q3-qpa-and-offers.csv | 1,587,953 | 14,852 | 1,189,746 |
| 2025 Q4 | federal-idr-puf-2025-q4-qpa-and-offers.csv | 1,419,980 | 12,296 | 1,073,178 |
Fields used
- Payment Determination Outcome; Default Decision
- Prevailing Party Offer as % of QPA
- Length of Time to Make Determination
- Location of Service
- Practice/Facility Specialty or Type
- Health Plan/Issuer Email Domain; Health Plan/Issuer Name (labels only)
- Type of Service Code; Service Code; Item or Service Description (labels only)
- QPA and Offers file: QPA; Prevailing Offer; Offer Selected from Provider or Issuer; Geographical Region; Service Code; Type of Service Code; Initiating Party and Air Ambulance Pick-up Location (to remove air ambulance rows)
Not used
- OON Air Ambulance file (out of scope).
- QPA and Offers files for 2023 Q1–2024 Q2 (service codes cannot be repaired; see methodology).
- CMS Supplemental Tables and bi-monthly reports.
- Provider names, NPIs and IDR entity names are not displayed on this site.
Reproducibility
The build is scripted end to end: harmonize the quarterly files, aggregate exact cells, render static pages. Each figure on the site can be traced to a cell in the build output.