COVID-19 InvestigationFebruary 16, 2026·4 min read
Who Got Paid the Most to Give COVID Vaccines?
We analyzed every Medicaid billing record for COVID-19 vaccinations. The top billers aren't who you'd expect — tribal hospitals and state agencies dominate the list.
Total Vaccine Spending
$158.7M
Vaccine Claims
5.7M
Beneficiaries
4.4M
When COVID-19 vaccines became available in late 2020, Medicaid became one of the primary payers for vaccinating low-income Americans. Vaccines were just one part of the pandemic spending surge — Medicaid also paid $4.7 billion for COVID testing and saw massive billing jumps across hundreds of providers. Our analysis of HHS billing data reveals some surprising patterns in who billed the most for vaccinations.
The tribal healthcare angle
Indian Health Service hospitals dominate the top of this list. Shiprock Hospital in New Mexico billed $11.8 million for COVID vaccinations alone. This highlights the scale of tribal healthcare infrastructure — and the disproportionate impact COVID had on Native American communities, who were prioritized for early vaccination.
Many of the top billers have blank or generic names in the NPI registry — these are typically federal or tribal facilities that register differently than private providers. The State of Indiana Auditor of State billed $6.1 million through its state-run vaccination sites, while Kaiser Permanente billed $4.8 million through its managed care network.
Top 10 COVID Vaccine Billers
4
Dhhs,phs,naihs, Gallup Indian Medical Center
General Acute Care Hospital · Gallup, NM
$5.9M
11K claims
7
Pine Ridge Indian Health Service Hospital
General Acute Care Hospital · Pine Ridge, SD
$4.3M
14K claims
All 100 Top Vaccine Billers
| # | Provider | State | Total Paid | Claims |
|---|---|---|---|---|
| 1 | DHHS PHS Naihs Shiprock HospitalGeneral Acute Care Hospital | NM | $11.8M | 23K |
| 2 | County of Santa ClaraCase Manager/Care Coordinator | CA | $6.3M | 162K |
| 3 | State of Indiana Auditor of StatePublic Health or Welfare | IN | $6.1M | 2.3M |
| 4 | Dhhs,phs,naihs, Gallup Indian Medical CenterGeneral Acute Care Hospital | NM | $5.9M | 11K |
| 5 | Zuni Indian HospitalGeneral Acute Care Hospital | NM | $5.5M | 10K |
| 6 | Permanente Medical Group INCAnesthesiology | CA | $4.8M | 124K |
| 7 | Pine Ridge Indian Health Service HospitalGeneral Acute Care Hospital | SD | $4.3M | 14K |
| 8 | PHS Indian HospitalGeneral Acute Care Hospital | MN | $3.8M | 7,335 |
| 9 | Rosebud Indian Health ServiceGeneral Acute Care Hospital | SD | $3.4M | 8,805 |
| 10 | DHHS PHS Naihs Crownpoint HospitalGeneral Acute Care Hospital | NM | $3.3M | 6,284 |
| 11 | Tanana Chiefs ConferenceClinic/Center Multi-Specialty | AK | $3.2M | 5,681 |
| 12 | Commonwealth MedicineClinic/Center, Public Health, State or Local | MA | $2.9M | 98K |
| 13 | County of Los AngelesClinic/Center, Public Health, State or Local | CA | $2.9M | 85K |
| 14 | Gregory HuhnInternal Medicine | IL | $2.6M | 82K |
| 15 | Permanente Medical Group INCInternal Medicine | CA | $2.6M | 76K |
| 16 | St. Johns Community HealthCase Manager/Care Coordinator | CA | $2.4M | 50K |
| 17 | Boston Medical Center CorporationGeneral Acute Care Hospital | MA | $2.3M | 143K |
| 18 | Medical Associates of EbnhcClinic/Center, Community Health | MA | $1.9M | 115K |
| 19 | The Commonwealth of MassachusettsPublic Health or Welfare | MA | $1.8M | 98K |
| 20 | The New York and Presbyterian HospitalGeneral Acute Care Hospital | NY | $1.7M | 49K |
| 21 | Southcentral FoundationClinic/Center, Multi-Specialty | AK | $1.6M | 5,862 |
| 22 | Legacy Clinics LLC | OR | $1.5M | 59K |
| 23 | The Griffin HospitalClinic/Center, Emergency Care | CT | $1.5M | 92K |
| 24 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.5M | 38K |
| 25 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.5M | 42K |
| 26 | Yale New Haven HospitalGeneral Acute Care Hospital | CT | $1.4M | 83K |
| 27 | Cdva CorpHealth Maintenance Organization | PR | $1.4M | 70K |
| 28 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.4M | 35K |
| 29 | Oregon Health & Science UniversityGeneral Practice | OR | $1.4M | 47K |
| 30 | Richard BoneInternal Medicine, Gastroenterology | IL | $1.4M | 34K |
| 31 | Group Health Plan, Inc.Clinic/Center, Multi-Specialty | MN | $1.3M | 36K |
| 32 | United Health Centers of the San Joaquin ValleyCase Manager/Care Coordinator | CA | $1.3M | 32K |
| 33 | The Arizona Partnership for ImmunizationLocal Education Agency (LEA) | AZ | $1.3M | 29K |
| 34 | Santa Fe Indian HospitalGeneral Acute Care Hospital | NM | $1.3M | 2,438 |
| 35 | Kaiser Foundation HospitalsGeneral Acute Care Hospital | CA | $1.3M | 36K |
| 36 | New York City Health and Hospitals CorporationInternal Medicine | NY | $1.3M | 43K |
| 37 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.3M | 35K |
| 38 | Kewa Pueblo Health CorporationClinic/Center | NM | $1.2M | 2,395 |
| 39 | New York City Health and Hospitals CorporationInternal Medicine | NY | $1.2M | 38K |
| 40 | Montefiore Medical CenterGeneral Acute Care Hospital | NY | $1.2M | 35K |
| 41 | Federico HerreraPediatrics | IL | $1.2M | 29K |
| 42 | Arkansas Childrens HospitalClinic/Center, Critical Access Hospital | AR | $1.1M | 13K |
| 43 | University of Colorado Hospital AuthorityGeneral Acute Care Hospital | CO | $1.1M | 15K |
| 44 | Utah Navajo Health System, IncorporatedFamily Medicine | UT | $1.1M | 3,664 |
| 45 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.1M | 31K |
| 46 | Dulce Health CenterClinic/Center, Public Health, Federal | NM | $1.1M | 2,025 |
| 47 | Park Nicollet ClinicObstetrics & Gynecology | MN | $1.0M | 29K |
| 48 | Permanente Medical Group INCAnesthesiology | CA | $1.0M | 27K |
| 49 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $1.0M | 27K |
| 50 | Mid Atlantic Pemanente Medical GroupHealth Maintenance Organization | MD | $1.0M | 63K |
| 51 | Kaiser Foundation Health Plan of the NorthwestGeneral Practice | OR | $1.0M | 27K |
| 52 | The General Hospital CorporationGeneral Acute Care Hospital | MA | $1.0M | 48K |
| 53 | Contra Costa CountyClinic/Center Federally Qualified Health Center (FQHC) | CA | $991K | 38K |
| 54 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $988K | 26K |
| 55 | St Regis Mohawk TribeSubstance Abuse Rehabilitation Facility | NY | $986K | 2,796 |
| 56 | City & County of San FranciscoCase Manager/Care Coordinator | CA | $986K | 40K |
| 57 | The Queens Medical CenterPsychiatric Unit | HI | $981K | 27K |
| 58 | New York City Health and Hospitals CorporationInternal Medicine | NY | $973K | 31K |
| 59 | North Shore-lij Medical PCUrology | NY | $965K | 25K |
| 60 | The Fort Defiance Indian Hospital Board, IncorporationGeneral Acute Care Hospital | AZ | $965K | 1,950 |
| 61 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $944K | 24K |
| 62 | Presbyterian Healthcare ServicesSurgery | NM | $943K | 27K |
| 63 | Great Plains Tribal Chairmen's Health BoardClinic/Center, Urgent Care | SD | $902K | 3,956 |
| 64 | Aurora Medical Group, Inc.Internal Medicine | WI | $898K | 31K |
| 65 | Mescalero Indian HospitalGeneral Acute Care Hospital, Rural | NM | $895K | 1,711 |
| 66 | City of ColumbusClinic/Center, Public Health, State or Local | OH | $868K | 22K |
| 67 | Arkansas Department of Health ImmunizationsPublic Health or Welfare | AR | $859K | 52K |
| 68 | Brockton Neighborhood Health CenterClinic/Center, Federally Qualified Health Center (FQHC) | MA | $848K | 36K |
| 69 | Alamo Navajo School Board, Inc.Clinic/Center, Primary Care | NM | $846K | 2,635 |
| 70 | Mississippi Band of Choctaw IndiansGeneral Acute Care Hospital | MS | $837K | 1,767 |
| 71 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $836K | 21K |
| 72 | Straub Clinic & HospitalClinic/Center, Multi-Specialty | HI | $828K | 25K |
| 73 | The Metrohealth SystemGeneral Acute Care Hospital | OH | $827K | 47K |
| 74 | Community Medical Associates, Inc.Clinical Neuropsychologist | KY | $826K | 31K |
| 75 | Permanente Medical Group INCAnesthesiology | CA | $819K | 24K |
| 76 | St. Johns Community HealthCase Manager/Care Coordinator | CA | $816K | 16K |
| 77 | Cambridge Public Health CommissionGeneral Acute Care Hospital | MA | $816K | 32K |
| 78 | Southern California Permanente Medical GroupHealth Maintenance Organization | CA | $816K | 21K |
| 79 | Contra Costa CountyClinic/Center Federally Qualified Health Center (FQHC) | CA | $800K | 25K |
| 80 | Novant Health Medical Group, LLCFamily Medicine | NC | $797K | 29K |
| 81 | Hennepin Healthcare System INCGeneral Acute Care Hospital | MN | $778K | 32K |
| 82 | White Earth Band of ChippewaHome Health | MN | $772K | 2,028 |
| 83 | Chinatown True Care Medical PLLCFamily Medicine | NY | $769K | 21K |
| 84 | Acoma-canoncito-laguna Indian Health CenterClinic/Center, Health Services | NM | $759K | 1,512 |
| 85 | Hartford HospitalGeneral Acute Care Hospital | CT | $757K | 49K |
| 86 | Pine Ridge Indian Health Service HospitalClinic/Center | SD | $734K | 1,436 |
| 87 | Virtua - West Jersey Health System Inc.General Acute Care Hospital | NJ | $726K | 43K |
| 88 | Centro De Diagnostico Y Tratamiento De San Sebastian INCClinic/Center, Health Services | PR | $722K | 23K |
| 89 | Homeland Health Specialists INCRegistered Nurse, Community Health | MN | $719K | 44K |
| 90 | Uch-mhsGeneral Acute Care Hospital | CO | $713K | 8,498 |
| 91 | County of MonroePublic Health or Welfare | NY | $712K | 22K |
| 92 | Children's Hospital CorporationClinic/Center | MA | $711K | 21K |
| 93 | Dallas County Hospital DistrictClinic/Center, Ambulatory Surgical | TX | $708K | 50K |
| 94 | Hmh Hospitals CorporationAmbulance | NJ | $698K | 43K |
| 95 | State of New MexicoPublic Health or Welfare | NM | $694K | 23K |
| 96 | Northeast Valley Health CorporationCase Manager/Care Coordinator | CA | $692K | 11K |
| 97 | Albuquerque Indian Health CenterClinic/Center | NM | $683K | 1,411 |
| 98 | Henry Ford Health SystemGeneral Acute Care Hospital | MI | $669K | 36K |
| 99 | Louisiana State University Health Sciences CenterOral & Maxillofacial Surgery | LA | $660K | 49K |
| 100 | Children's Hospital & Research Center at OaklandGeneral Acute Care Hospital | CA | $659K | 12K |
Key Takeaways
- ▸Indian Health Service and tribal hospitals are the top vaccine billers — reflecting the massive vaccination effort in Native communities.
- ▸State agencies (Indiana, others) served as direct billing entities for state-run vaccination sites.
- ▸Many top vaccine billers have blank names in the NPI database — these are typically federal/tribal facilities with non-standard registration.
- ▸Total Medicaid vaccine spending across the top 100 billers: $158.7M.
Source: HHS Medicaid Provider Spending Data (2018–2024) · 227M records