The Medicaid by Drug dataset presents information on spending for covered outpatient drugs prescribed to beneficiaries enrolled in Medicaid by physicians and other healthcare professionals. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. Units refer to the drug unit in the lowest dispensable amount. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications. Drug spending metrics for Medicaid represent the total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the drug. Medicaid drug spending contains both the Federal and State reimbursement and is inclusive of any applicable dispensing fees. In addition, this total is not reduced or affected by Medicaid rebates paid to the states.

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File (PUF), with information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The Part D Prescriber PUF is based on information from CMS’s Chronic Conditions Data Warehouse, which contains Prescription Drug Event records submitted by Medicare Advantage Prescription Drug (MAPD) plans and by stand-alone Prescription Drug Plans (PDP). The dataset identifies providers by their National Provider Identifier (NPI) and the specific prescriptions that were dispensed at their direction, listed by brand name (if applicable) and generic name. For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers. Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D prescriptions, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physician’s entire practice or all of Medicare as it only includes information on beneficiaries enrolled in the Medicare Part D prescription drug program (i.e., approximately two-thirds of all Medicare beneficiaries). In addition, the data are not intended to indicate the quality of care provided. For additional limitations, please review the methodology document in the About tab.

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

The Medicare Part D Prescribers by Provider and Drug dataset provides information on prescription drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other health care providers. This dataset contains the total number of prescription fills that were dispensed and the total drug cost paid organized by prescribing National Provider Identifier (NPI), drug brand name (if applicable) and drug generic name. Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

Our objective is to ensure that providers who bill Federal health care programs do not submit claims for services furnished, ordered or prescribed by an excluded individual or entity. The LEIE is updated monthly with all individuals and entities who have been excluded from participation in Federal health care programs. Providers who bill Medicare, Medicaid, or other Federal health care programs must ensure that they know what individuals or entities are excluded and not bill for their services (e.g., a pharmacy should not bill Medicaid for a drug prescribed by an excluded physician nor for drugs dispensed by an excluded pharmacist).

The Medicare Part D Prescribers by Provider dataset contains information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The dataset identifies providers by their National Provider Identifier (NPI) and summarizes for each prescriber the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

The data below contains newly reported, active covered outpatient drugs which were reported by participating drug manufacturers since the last quarterly update of the Drug Products in the Medicaid Drug Rebate Program (MDRP) database.

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

description:

Drug Utilization Review Annual Report, Excluded Drug Coverage by State Medicaid Program, State Drug Utilization Data

Drug Utilization Review Annual Report, Excluded Drug Coverage by State Medicaid Program, State Drug Utilization Data

This data set contains drug utilization data for Utah's covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

The data below contains newly reported, active covered outpatient drugs which were reported by participating drug manufacturers since the last quarterly update of the Drug Products in the Medicaid Drug Rebate Program (MDRP) database.

This dataset tracks the updates made on the dataset "Product Data for Newly Reported Drugs in the Medicaid Drug Rebate Program 03-24-2025-to-03-30-2025" as a repository for previous versions of the data and metadata.

This dataset tracks the updates made on the dataset "Product Data for Newly Reported Drugs in the Medicaid Drug Rebate Program 02-17-2025-to-02-23-2025" as a repository for previous versions of the data and metadata.

This dataset tracks the updates made on the dataset "Product Data for Newly Reported Drugs in the Medicaid Drug Rebate Program 2023-11-27-to-2023-12-03" as a repository for previous versions of the data and metadata.

The Monthly Prescription Drug Plan Formulary and Pharmacy Network Information files contain formulary and pharmacy network data for Medicare Prescription Drug Plans and Medicare Advantage (MA) Prescription Drug Plans (with the exception of employer and Program of All-Inclusive Care for the Elderly plans). Notice: CMS has identified an issue that resulted in a 15% coinsurance for plans with Defined Standard benefits to be listed rather than a 25% coinsurance in the Beneficiary Cost File under certain scenarios. This issue affected the October 2023 to November 2024 data. CMS will re-post the corrected data in batches between now and May 2025. The following files have already been corrected and re-posted: October 2024 November 2024 These non-identifiable files are available on a monthly basis and are comprised of the following tables: Plan Information - Information such as plan name, contract ID, plan ID, service area, and plan type. Geographic Locator - MA and Prescription Drug Plans region codes and county codes. Basic Drugs Formulary - Formulary details for each plan including National Drug Codes (NDCs), cost share tier level, and indicators for step therapy, quantity limits, and prior authorization. Excluded Drugs Formulary - Enhanced alternative plans may elect to provide a supplemental benefit and cover excluded drugs. File includes formulary details for excluded drugs that are covered by the plan (for enhanced alternative plans only). Beneficiary Cost - Plan level cost sharing details for preferred, non-preferred, and mail order network pharmacies. Pharmacy Network - National Provider Identifier (NPI) numbers for each network pharmacy including preferred, retail, and mail order indicators. Indication Based Coverage Formulary File - Includes drugs covered based on FDA-approved indication for each plan. Insulin Beneficiary Cost File - Plan level cost sharing details for insulin at preferred, non-preferred and mail order network pharmacies. These are large files and can take time to download. Please read the “Agreement for Use” in the Resources section below. This document contains important information regarding timeframes for obtaining data as well as data accuracy and integrity. The Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information is also available to access for the quarterly level information. Please note: The Part D benefit year information for plans become available in October of the year prior. For example, year 2024 data is available in the October, November and December 2023 monthly files. Year 2024 data continues to be available in the January through September 2024 monthly files, then beginning in October of 2024 year 2025 data becomes available. Estimated release dates for upcoming 2025 monthly data (files reflect data for the month in which the file is released): 2/26/25 3/26/25 4/23/25 5/21/25 6/18/25 7/30/25 8/27/25 9/24/25 Files older than contract year 2019 can be purchased.

This dataset tracks the updates made on the dataset "Product Data for Newly Reported Drugs in the Medicaid Drug Rebate Program 2023-10-02-to-2023-10-08" as a repository for previous versions of the data and metadata.