The CMS Program Statistics - Medicare Total Enrollment tables provide data on characteristics of the Medicare-covered populations. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR ENROLL AB 1. Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment, Yearly Trend MDCR ENROLL AB 2. Total Medicare Enrollment: Total, Original Medicare, Medicare Advantage and Other Health Plan Enrollment, and Resident Population, by Area of Residence MDCR ENROLL AB 3. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend MDCR ENROLL AB 4. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend MDCR ENROLL AB 5. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics MDCR ENROLL AB 6. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics MDCR ENROLL AB 7. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence MDCR ENROLL AB 8. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

This series of files links two large population-based sources providing detailed data about Medicare beneficiaries with cancer. The SEER (Surveillance, Epidemiology, and End Results) program consists of clinical, demographic, and cause of death information collected from tumor registries beginning in January 1, 1973. The Medicare contribution includes all claims for covered health care services from beneficiaries’ time of eligibility until death. Linkage is processed biennially by SEER and Centers for Medicare and Medicaid Services (CMS) staff. 95% of individuals age 65 and older are included in the SEER files. Due to privacy concerns, access to this database requires an application, SEER-Medicare Data Use Agreement (DUA), and documentation of institutional review board approval. Additionally, the National Cancer Institute’s information technology contractor assesses a processing fee the amount of which is dependent upon the type and number of files requested.

Context

The CMS National Plan and Provider Enumeration System (NPPES) was developed as part of the Administrative Simplification provisions in the original HIPAA act. The primary purpose of NPPES was to develop a unique identifier for each physician that billed medicare and medicaid. This identifier is now known as the National Provider Identifier Standard (NPI) which is a required 10 digit number that is unique to an individual provider at the national level.

Once an NPI record is assigned to a healthcare provider, parts of the NPI record that have public relevance, including the provider’s name, speciality, and practice address are published in a searchable website as well as downloadable file of zipped data containing all of the FOIA disclosable health care provider data in NPPES and a separate PDF file of code values which documents and lists the descriptions for all of the codes found in the data file.

Content

The dataset contains the latest NPI downloadable file in an easy to query BigQuery table, npi_raw. In addition, there is a second table, npi_optimized which harnesses the power of Big Query’s next-generation columnar storage format to provide an analytical view of the NPI data containing description fields for the codes based on the mappings in Data Dissemination Public File - Code Values documentation as well as external lookups to the healthcare provider taxonomy codes . While this generates hundreds of columns, BigQuery makes it possible to process all this data effectively and have a convenient single lookup table for all provider information.

Fork this kernel to get started.

Acknowledgements

https://bigquery.cloud.google.com/dataset/bigquery-public-data:nppes?_ga=2.117120578.-577194880.1523455401

https://console.cloud.google.com/marketplace/details/hhs/nppes?filter=category:science-research

Dataset Source: Center for Medicare and Medicaid Services. This dataset is publicly available for anyone to use under the following terms provided by the Dataset Source - http://www.data.gov/privacy-policy#data_policy — and is provided "AS IS" without any warranty, express or implied, from Google. Google disclaims all liability for any damages, direct or indirect, resulting from the use of the dataset.

Banner Photo by @rawpixel from Unplash.

Inspiration

What are the top ten most common types of physicians in Mountain View?

What are the names and phone numbers of dentists in California who studied public health?

Context

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarize counts of enrollees who are dually-eligible for both Medicare and Medicaid program, including those in Medicare Savings Programs. “Duals” represent 20 percent of all Medicare beneficiaries, yet they account for 34 percent of all spending by the program, according to the Commonwealth Fund . As a representation of this high-needs, high-cost population, these data offer a view of regions ripe for more intensive care coordination that can address complex social and clinical needs. In addition to the high cost savings opportunity to deliver upstream clinical interventions, this population represents the county-by-county volume of patients who are eligible for both state level (Medicaid) and federal level (Medicare) reimbursements and potential funding streams to address unmet social needs across various programs, waivers, and other projects. The dataset includes eligibility type and enrollment by quarter, at both the state and county level. These data represent monthly snapshots submitted by states to the CMS, which are inherently lower than ever-enrolled counts (which include persons enrolled at any time during a calendar year.) For more information on dually eligible beneficiaries

Querying BigQuery tables

You can use the BigQuery Python client library to query tables in this dataset in Kernels. Note that methods available in Kernels are limited to querying data. Tables are at bigquery-public-data.sdoh_cms_dual_eligible_enrollment.

Sample Query

In what counties in Michigan has the number of dual-eligible individuals increased the most from 2015 to 2018? Find the counties in Michigan which have experienced the largest increase of dual enrollment households

duals_Jan_2015 AS ( SELECT Public_Total AS duals_2015, County_Name, FIPS FROM bigquery-public-data.sdoh_cms_dual_eligible_enrollment.dual_eligible_enrollment_by_county_and_program WHERE State_Abbr = "MI" AND Date = '2015-12-01' ),

duals_increase AS ( SELECT d18.FIPS, d18.County_Name, d15.duals_2015, d18.duals_2018, (d18.duals_2018 - d15.duals_2015) AS total_duals_diff FROM duals_Jan_2018 d18 JOIN duals_Jan_2015 d15 ON d18.FIPS = d15.FIPS )

SELECT * FROM duals_increase WHERE total_duals_diff IS NOT NULL ORDER BY total_duals_diff DESC

NCHS has linked data from various surveys with Medicare program enrollment and health care utilization and expenditure data from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and costs, and prescription drug use among Medicare enrollees. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and June 30, 2024. The data were used to generate the Medicare Telehealth Trends Report.

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage.

DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

Content

The hospital readmission rate PUF presents nation-wide information about inpatient hospital stays that occurred within 30 days of a previous inpatient hospital stay (readmissions) for Medicare fee-for-service beneficiaries. The readmission rate equals the number of inpatient hospital stays classified as readmissions divided by the number of index stays for a given month. Index stays include all inpatient hospital stays except those where the primary diagnosis was cancer treatment or rehabilitation. Readmissions include stays where a beneficiary was admitted as an inpatient within 30 days of the discharge date following a previous index stay, except cases where a stay is considered always planned or potentially planned. Planned readmissions include admissions for organ transplant surgery, maintenance chemotherapy/immunotherapy, and rehabilitation.

This dataset has several limitations. Readmissions rates are unadjusted for age, health status or other factors. In addition, this dataset reports data for some months where claims are not yet final. Data published for the most recent six months is preliminary and subject to change. Final data will be published as they become available, although the difference between preliminary and final readmission rates for a given month is likely to be less than 0.1 percentage point.

Data Source: The primary data source for these data is the CMS Chronic Condition Data Warehouse (CCW), a database with 100% of Medicare enrollment and fee-for-service claims data. For complete information regarding data in the CCW, visit http://ccwdata.org/index.php. Study Population: Medicare fee-for-service beneficiaries with inpatient hospital stays.

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Justyn Warner on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under NA

The datasets include the monthly count of individuals who are enrolled in Medicare Savings Programs (MSP), by aid code and county. The counts reflect the total number of eligible individuals enrolled during the month. MSP help individuals with limited income and resources pay for some of the out-of-pocket costs for Medicare, including Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. There are four Medicare Savings Programs: Qualified Medicare Beneficiary (QMB), Specified Low Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Working Disabled Individual (QWDI). Individuals who are eligible for QMB, SLMB, and QI also automatically qualify for the Low Income Subsidy (or “Extra Help”) program, which helps lower the cost of prescription drugs. Counties and aid codes with zero individuals enrolled during a reporting period are not included in the dataset.

Verify the accuracy of SSNs of all individual Medicare providers, owners, managing/directing employees, authorized representatives, ambulance service medical directors, ambulance crew members, technicians, chain organization administrators, Independent Diagnostic Test Facility (IDTF), supervising/directing physicians, and IDTF interpretation service providers. Also included in this Agreement are individual health care providers who apply for a National Provider Identification Number (NPI).

The MBSF mortality denominator can be used to study mortality rates of the elder population in the US. Access to CMS data is restricted. Processed datasets cannot be shared. Contact the authors if you've purchased CMS data through RESDAC and would like to use our data processing pipelines to clean CMS raw data and generate the MBSF mortality denominator. Medicare Overview In the United States, when individuals reach the age of 65, they become eligible for the Medicare federal health insurance program. Medicare also covers individuals under 65 if they have certain disabilities or End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). About CMS The Center for Medicare & Medicaid Services (CMS) is the federal agency responsible for managing the Medicare and Medicaid data. CMS makes predefined datasets available for purchase to researchers after they enter a Data usage agreement through Research Data Assistance Center (ResDAC). Master Beneficiary Summary File (MBSF) A beneficiary-level data from CMS/ResDAC is known as the Master Beneficiary Summary File (MBSF). The raw MBSF data contains basic demographic information of individuals, an indicator of death, and some details on their medicare enrollment. Mortality Denominator We refer to the mortality denominator as the clean subset of MBSF health data that is representative of the older population. The subset consists of the US elder population; notably, individuals under 64 who qualified because of a disability are excluded.

Content

This crosswalk links the types of providers and suppliers who are eligible to apply for enrollment in the Medicare program with the appropriate Healthcare Provider Taxonomy Codes. This crosswalk includes the Medicare Specialty Codes for those provider/supplier types who have Medicare Specialty Codes. The Healthcare Provider Taxonomy Code Set is available from the Washington Publishing Company (www.wpc-edi.com) and is maintained by the National Uniform Claim Committee (www.nucc.org). The code set is updated twice a year, with the updates being effective April 1 and October 1 of each year. This document reflects Healthcare Provider Taxonomy Codes effective for use on April 2, 2018.

When changes are made to Medicare provider enrollment requirements, the Medicare Specialty Codes, or the Healthcare Provider Taxonomy Code Set, this document may need to be revised.

NOTE: This document does not alter existing Medicare claims preparation, processing, or payment instructions, nor does it alter existing Medicare provider enrollment requirements or policies.

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Markus Spiske on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under NA

Hospitals Registered with MedicareThis feature layer, utilizing data from the Centers of Medicare and Medicaid Services (CMS), depicts all hospitals that are currently registered with Medicare in the U.S. Per NIH, "Since the passage of Medicare legislation in 1965, Section 1861 of the Social Security Act has stated that hospitals participating in Medicare must meet certain requirements specified in the act and that the Secretary of the Department of Health, Education and Welfare (HEW) [now the Department of Health and Human Services (DHHS)] may impose additional requirements found necessary to ensure the health and safety of Medicare beneficiaries receiving services in hospitals. On this basis, the Conditions of Participation, a set of regulations setting minimum health and safety standards for hospitals participating in Medicare, were promulgated in 1966 and substantially revised in 1986."Ascension Columbia St Mary's HospitalData currency: 11/26/2024Data modification: This data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsSupport documentation: Data dictionaryFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters of Medicare and Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

Analysis of ‘Medicare Telemedicine Snapshot’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/aaa68d71-2f71-44e8-bd0c-a24abe8758bb on 11 February 2022.

--- Dataset description provided by original source is as follows ---

The Medicare Telemedicine dataset provides information about people with Medicare who utilized telemedicine services between March 1, 2020 and February 28, 2021.

--- Original source retains full ownership of the source dataset ---

The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.

1. This dataset is a de-identified summary table of vision and eye health data indicators from Medicare claims and encounters, stratified by all available combinations of age group, race/ethnicity, gender, and state. Medicare FFS + Advantage data for VEHSS includes beneficiaries who were fully enrolled in Medicare Part B (Fee-for-Service (FFS)) or Medicare Part C (Medicare Advantage) for the duration of the year. Medicare claims provide a convenience sample that is approximately representative of the US population aged 65 and older, and contains data for certain individuals younger than age 65 who are eligible for Medicare for other reasons, including disability due to blindness. Medicare data for VEHSS include Service Utilization and Medical Diagnoses indicators. Data were suppressed for de-identification to ensure protection of patient privacy. Data will be updated as it becomes available. Historical data for Medicare FFS only is available on VEHSS from 2014. Detailed information on VEHSS Medicare analyses can be found on the VEHSS Medicare webpage (cdc.gov/visionhealth/vehss/data/claims/medicare.html). Information on available Medicare claims data can be found on the ResDac website (www.resdac.org). The VEHSS Medicare dataset was last updated May 2025.

Data consist of CMS Medicare data files which are restricted access and cannot be released publicly. This dataset is not publicly accessible because: EPA cannot release personally identifiable information regarding living individuals, according to the Privacy Act and the Freedom of Information Act (FOIA). This dataset contains information about human research subjects. Because there is potential to identify individual participants and disclose personal information, either alone or in combination with other datasets, individual level data are not appropriate to post for public access. Restricted access may be granted to authorized persons by contacting the party listed. EPA cannot release CBI, or data protected by copyright, patent, or otherwise subject to trade secret restrictions. Request for access to CBI data may be directed to the dataset owner by an authorized person by contacting the party listed. It can be accessed through the following means: CMS Medicare data are available from: https://www.cms.gov/data-research/files-for-order/data-disclosures-and-data-use-agreements-duas/limited-data-set-lds with the requirement of a signed Data Use Agreement. . Weather data are available at https://prism.oregonstate.edu/. Format: The data that support the findings of this study are available from the Centers for Medicare and Medicaid Services (CMS). Restrictions apply to the availability of these data, which were provided under a Data Use Agreement specific to this study. Data are available from: https://www.cms.gov/data-research/files-for-order/data-disclosures-and-data-use-agreements-duas/limited-data-set-lds with the requirement of a signed Data Use Agreement. Data do not contain personally identifiable information but contain are classified as Limited Data Set files and their distribution require an agreement and between CMS and the requester and approval by CMS. Weather data are available at https://prism.oregonstate.edu/. Because the data do not contain identifiable private information and were not obtained through interaction or intervention with individuals, the Institutional Review Board for the University of North Carolina and the US Environmental Protection Agency Human Research Protocol Officer determined that use of this data does not constitute human subjects research. This dataset is associated with the following publication: Wade, T., and C. Herbert. Weather conditions and legionellosis: a nationwide case-crossover study among Medicare recipients. EPIDEMIOLOGY AND INFECTION. Cambridge University Press, Cambridge, UK, 152: E125, (2024).

Nursing Home Compare has detailed information about every Medicare and Medicaid nursing home in the country. A nursing home is a place for people who can’t be cared for at home and need 24-hour nursing care. These are the official datasets used on the Medicare.gov Nursing Home Compare Website provided by the Centers for Medicare & Medicaid Services. These data allow you to compare the quality of care at every Medicare and Medicaid-certified nursing home in the country, including over 15,000 nationwide.

Enrollment includes both Medicaid-only and Medicare-Medicaid (“dual”) enrollees. For both types of enrollees, Medicaid covers LTSS. For dual enrollees, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare, and other non-LTSS services that are not covered by Medicare. Some comprehensive managed care programs enroll beneficiaries who may be at risk of needing LTSS but do not receive any LTSS. These counts only include individuals that receive LTSS. Moreover, states differ in their ability to report individuals who use MLTSS versus those who are enrolled (and may or may not be using LTSS). This table reports MLTSS users unless otherwise noted. Comprehensive Managed Care Including LTSS does not include PACE programs. MLTSS Only programs cover LTSS under capitation; acute, primary, and specialty care services for these enrollees may be covered by another Medicaid MCO, Medicaid FFS, or by Medicare for dual enrollees. These data include states that provide MLTSS plus other benefits in a package that does not include inpatient medical care. The indicated territory was not able to supply data for this report. The Northern Mariana Islands reported that they have no Medicaid managed care enrollment, but they did not report total Medicaid enrollees. Enrollment and user counts include both Medicaid-only enrollees and dually eligible individuals. For both types of enrollees, Medicaid covers LTSS. For dually eligible individuals, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare, and other non-LTSS services that are not covered by Medicare. The “Comprehensive Managed Care Including LTSS” column does not include PACE programs. Columns indicating the "Number of enrollees using LTSS" reflect what states reported. In addition to the three states that reported LTSS users (Arizona, New York and Wisconsin), California and Delaware also offer LTSS services in a stand-alone program. Note: "n/a" indicates that a state or territory was not able to report data or does not have a managed care program. "--" indicates that a state or territory does not operate programs of the type listed in the column heading. Enrollment and user counts include both Medicaid-only and dually eligible individuals. For both types of enrollees, Medicaid covers LTSS. For dually eligible individuals, Medicaid may also cover Medicare cost-sharing for acute, primary care, and specialty services covered by Medicare and other non-LTSS services that are not covered by Medicare. Columns indicating the "Number of enrollees using LTSS" reflect what states reported. In addition to the three states that reported LTSS users (Arizona, New York and Wisconsin), California and Delaware also offer LTSS services in a stand-alone program.

This directory contains analytic code used to build cohorts, dependent variables, and covariates, and run all statistical analyses for the study, "Changes in care associated with integrating Medicare and Medicaid for dual eligible individuals: Examination of a Fully Integrated Special Needs Plan."The code files enclosed in this directory are:SAS_Cohorts_Outcomes 23-9-30.sas. This SAS code file builds study cohorts, dependent variables, and covariates. This code produced a person-by-month level database of outcomes and covariates for individuals in the integration and comparison cohorts.STATA_Models_23-6-5_weight_jama.do. This Stata program reads in the person-by-month level database (output from SAS) and conducts all statistical analyses used to produce the main and supplementary analyses reported in the manuscript.We have provided this code and documentation to disclose our study methods. Our Data Use Agreements prohibit publishing of row-level data for this study. Therefore, researchers would need to obtain Data Use Agreements with data providers to implement these analyses. We also note that some measures reference macros with proprietary code (e.g., Medispan® files) which require a separate user license to run. Interested readers should contact the study PI, Eric T. Roberts (eric.roberts@pennmedicine.upenn.edu) for further information.