High Cost Claims by Zip Code

Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download.

This dataset provides information related to the 100 most costly diagnostic claims. It contains information about the total number of recipients, total number of claims, and total dollar amount, grouped by recipient location.

Restricted to claims with service date between 01/2012 to 12/2017. Restricted to top 100 costly diagnosis codes (by total cost). Provider is the billing provider. If a claim has several diagnostic codes, primary diagnosis is used. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.