The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI). 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.

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.

The CMS Program Statistics - Medicare Providers summary tables provide data on institutional (i.e., hospitals, skilled nursing facilities, home health agencies, hospices, etc.) and non-institutional (i.e., physicians, nonphysicians, specialists, and suppliers) providers. 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 PROVIDERS 1. Medicare Providers: Number of Medicare Certified Institutional Providers, Yearly Trend MDCR PROVIDERS 2. Medicare Providers: Number of Medicare Certified Inpatient Hospital and Skilled Nursing Facility Beds and Beds Per 1,000 Enrollees, Yearly Trend MDCR PROVIDERS 3. Medicare Providers: Number of Medicare Certified Facilities, by Type of Control, Yearly Trend MDCR PROVIDERS 4. Medicare Providers: Number of Skilled Nursing Facilities and Medicare Certified Hospitals, and Number of Beds, by State, Territories, Possessions and Other Areas MDCR PROVIDERS 5. Medicare Providers: Number of Medicare Certified Providers, by Type of Provider, by State, Territories, Possessions, and Other Areas MDCR PROVIDERS 6. Medicare Providers: Number of Medicare Non-Institutional Providers by Specialty, Yearly Trend MDCR PROVIDERS 7. Medicare Providers: Number of Medicare Non-Institutional Providers, by State, Territories, Possessions, and Other Areas, Yearly Trend

Abstract

The MarketScan Medicare Supplemental Database provides detailed cost, use and outcomes data for healthcare services performed in both inpatient and outpatient settings.

It Include Medicare Supplemental records for all years, and Medicare Advantage records starting in 2020. This page also contains the MarketScan Medicare Lab Database starting in 2018.

Starting in 2026, there will be a data access fee for using the full dataset. Please refer to the 'Usage Notes' section of this page for more information.

Methodology

MarketScan Research Databases are a family of data sets that fully integrate many types of data for healthcare research, including:

• De-identified records of more than 250 million patients (medical, drug and dental)

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• Laboratory results

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• Hospital discharges

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The MarketScan Databases track millions of patients throughout the healthcare system. The data are contributed by large employers, managed care organizations, hospitals, EMR providers and Medicare.

Usage

This page contains the MarketScan Medicare Database.

We also have the following on other pages:

• The MarketScan Commercial Database
• The MarketScan Dental Database
• The MarketScan Benefit Plan Design data
• MarketScan Redbook (The MarketScan Code Reference Book)

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**Starting in 2026, there will be a data access fee for using the full dataset **

(though the 1% sample will remain free to use). The pricing structure and other

**relevant information can be found in this **FAQ Sheet.

Before Manuscript Submission

All manuscripts (and other items you'd like to publish) must be submitted to

support@stanfordphs.freshdesk.com for approval prior to journal submission.

We will check your cell sizes and citations.

For more information about how to cite PHS and PHS datasets, please visit:

https:/phsdocs.developerhub.io/need-help/citing-phs-data-core

Data Documentation

Data access is required to view this section.

Section 2

Metadata access is required to view this section.

Section 3

Metadata access is required to view this section.

description:

The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions. The database also includes several other types of National Coverage policy related documents, including National Coverage Analyses (NCAs), Coding Analyses for Labs (CALs), Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) proceedings, and Medicare coverage guidance documents.

The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD decisions. The database also includes several other types of National Coverage policy related documents, including National Coverage Analyses (NCAs), Coding Analyses for Labs (CALs), Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) proceedings, and Medicare coverage guidance documents.

The Medicare Physician & Other Practitioners by Provider and Service dataset provides information on use, payments, and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service.

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.

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 CMS Program Statistics - Medicare Part A & Part B - All Types of Service tables provide use and payment data by type of coverage and type of service. 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 SUMMARY AB 1. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for All Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 2. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Aged Original Medicare Beneficiaries, by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 3. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Disabled Original Medicare Beneficiaries by Type of Coverage and Type of Service, Yearly Trend MDCR SUMMARY AB 4. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage, Demographic Characteristics, and Medicare-Medicaid Enrollment Status MDCR SUMMARY AB 5. Medicare Part A and Part B Summary: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Coverage and by Area of Residence MDCR SUMMARY AB 6. Medicare Part A and Part B Summary: Utilization and Program Payments for Original Medicare Beneficiaries, by Type of Entitlement, Amount of Program Payments, Type of Coverage, and Type of Service

Contains full API download of all available datasets on data.medicaid.gov. Program overview Data.Medicaid.gov is a public platform offering open access to a diverse range of datasets related to Medicaid and the Children’s Health Insurance Program (CHIP). It is tailored to support policymakers, researchers, and the general public by providing critical data for research, reporting, and analysis. The platform covers various topics, including state Medicaid and CHIP programs, enrollment statistics, spending trends, and quality metrics. With data presented in multiple formats, it promotes transparency, allowing users to track program performance and make informed decisions based on reliable insights.

Information on utilization and payment data for Home health agency, Hospice, skilled nursing facitlity. Information on Inpatient Prospective Payment System (IPPS) payments, Inpatient Rehabilitation Facilities (IRFs)

This dataset tracks the updates made on the dataset "NCHS Survey Data Linked to Centers for Medicare & Medicaid Services (CMS) 1999-2013 Medicare Data" as a repository for previous versions of the data and metadata.

Context

This dataset contains Hospital General Information from the U.S. Department of Health & Human Services. This is the BigQuery COVID-19 public dataset. This data contains a list of all hospitals that have been registered with Medicare. This list includes addresses, phone numbers, hospital types and quality of care information. The quality of care data is provided for over 4,000 Medicare-certified hospitals, including over 130 Veterans Administration (VA) medical centers, across the country. You can use this data to find hospitals and compare the quality of their care

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.cms_medicare.hospital_general_info.

Sample Query

How do the hospitals in Mountain View, CA compare to the average hospital in the US? With the hospital compare data you can quickly understand how hospitals in one geographic location compare to another location. In this example query we compare Google’s home in Mountain View, California, to the average hospital in the United States. You can also modify the query to learn how the hospitals in your city compare to the US national average.

“#standardSQL SELECT MTV_AVG_HOSPITAL_RATING, US_AVG_HOSPITAL_RATING FROM ( SELECT ROUND(AVG(CAST(hospital_overall_rating AS int64)),2) AS MTV_AVG_HOSPITAL_RATING FROM bigquery-public-data.cms_medicare.hospital_general_info WHERE city = 'MOUNTAIN VIEW' AND state = 'CA' AND hospital_overall_rating <> 'Not Available') MTV JOIN ( SELECT ROUND(AVG(CAST(hospital_overall_rating AS int64)),2) AS US_AVG_HOSPITAL_RATING FROM bigquery-public-data.cms_medicare.hospital_general_info WHERE hospital_overall_rating <> 'Not Available') ON 1 = 1”

What are the most common diseases treated at hospitals that do well in the category of patient readmissions? For hospitals that achieved “Above the national average” in the category of patient readmissions, it might be interesting to review the types of diagnoses that are treated at those inpatient facilities. While this query won’t provide the granular detail that went into the readmission calculation, it gives us a quick glimpse into the top disease related groups (DRG)
, or classification of inpatient stays that are found at those hospitals. By joining the general hospital information to the inpatient charge data, also provided by CMS, you could quickly identify DRGs that may warrant additional research. You can also modify the query to review the top diagnosis related groups for hospital metrics you might be interested in. “#standardSQL SELECT drg_definition, SUM(total_discharges) total_discharge_per_drg FROM bigquery-public-data.cms_medicare.hospital_general_info gi INNER JOIN bigquery-public-data.cms_medicare.inpatient_charges_2015 ic ON gi.provider_id = ic.provider_id WHERE readmission_national_comparison = 'Above the national average' GROUP BY drg_definition ORDER BY total_discharge_per_drg DESC LIMIT 10;”

The Healthcare Provider Cost Report Information System (HCRIS) contains annual reports submitted by Medicare-certified institutional providers to Medicare Administrative Contractors (MAC). This dataset contains all numeric data reported on a cost report such as costs, charges, ratios, number of beds, etc.

The Medicare Fee-For-Service Public Provider Enrollment dataset includes information on providers who are actively approved to bill Medicare or have completed the 855O at the time the data was pulled from the Provider Enrollment, Chain, and Ownership System (PECOS). The release of this provider enrollment data is not related to other provider information releases such as Physician Compare or Data Transparency. 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.

The Medicare Current Beneficiary Survey (MCBS) - Survey File Microdata Public Use File (PUF) dataset provides information on topics such as Medicare beneficiaries' access to care, health status, other information regarding beneficiaries’ knowledge of, attitudes toward, and satisfaction with their health care, as well as demographic data and information on all types of health insurance coverage.Resources for Using and Understanding the DataThis dataset is based on information from the MCBS and administrative data. The MCBS is a continuous, multi-purpose longitudinal survey covering a representative national sample of the Medicare population, including the population of beneficiaries aged 65 and over and beneficiaries aged 64 and below with certain disabling conditions. The MCBS collects this information in three data collection periods, or rounds, per year. Disclosure protections have been applied to the file, including de-identification and other methods. As a result, the MCBS Survey File Microdata file does not require a Data Use Agreement (DUA). In contrast, the MCBS Limited Data Set (LDS) releases contain beneficiary-level protected health information (PHI) and therefore require a DUA. The MCBS - Survey File Microdata file is not intended to replace the more detailed LDS files but, rather, it makes available a general-use publicly-available alternative that provides the highest degree of protection to the Medicare beneficiaries’ PHI. The main benefits of using the MCBS - Survey File Microdata file are:Increased data access for researchers of the MCBS through a free file download that is consistent with other U.S. Department of Health and Human Services (HHS) public-use survey files.Enhanced potential for policy-relevant analyses, by attracting new researchers and policymakers. Accessing the MCBS LDS can be a significant deterrent due to the associated costs and time but the MCBS - Survey File Microdata file mitigates these barriers to encourage broader utilization. A link to the more detailed MCBS LDS files is provided in the Resources section on this page. MCBS LDS data are also presented in the MCBS Chartbook linked in the Visualization section on this page.

This dataset identifies providers in Utah 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.

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarizes the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. The dataset includes the following data - common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions. Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure. This public dataset is hosted in Google BigQuery and is included in BigQuery's 1TB/mo of free tier processing. This means that each user receives 1TB of free BigQuery processing every month, which can be used to run queries on this public dataset. Watch this short video to learn how to get started quickly using BigQuery to access public datasets. What is BigQuery .

This is a peer-reviewed supplementary table for the article 'Healthcare resource utilization, costs and treatment associated with myasthenia gravis exacerbations among patients with myasthenia gravis in the USA: a retrospective analysis of claims data' published in the Journal of Comparative Effectiveness Research.Supplementary Table 1: MG treatment definitionsAim: There are limited data on the clinical and economic burden of exacerbations in patients with myasthenia gravis (MG). We assessed patient clinical characteristics, treatments and healthcare resource utilization (HCRU) associated with MG exacerbation. Patients & methods: This was a retrospective analysis of adult patients with MG identified by commercial, Medicare or Medicaid insurance claims from the IBM MarketScan database. Eligible patients had two or more MG diagnosis codes, without evidence of exacerbation or crisis in the baseline period (12 months prior to index [first eligible MG diagnosis]). Clinical characteristics were evaluated at baseline and 12 weeks before each exacerbation. Number of exacerbations, MG treatments and HCRU costs associated with exacerbation were described during a 2-year follow-up period. Results: Among 9352 prevalent MG patients, 34.4% (n = 3218) experienced ≥1 exacerbation after index: commercial, 53.0% (n = 1706); Medicare, 39.4% (n = 1269); and Medicaid, 7.6% (n = 243). During follow-up, the mean (standard deviation) number of exacerbations per commercial and Medicare patient was 3.7 (7.0) and 2.7 (4.1), respectively. At least two exacerbations were experienced by approximately half of commercial and Medicare patients with ≥1 exacerbation. Mean total MGrelated healthcare costs per exacerbation ranged from $26,078 to $51,120, and from $19,903 to $49,967 for commercial and Medicare patients, respectively. AChEI use decreased in patients with multiple exacerbations, while intravenous immunoglobulin use increased with multiple exacerbations. Conclusion: Despite utilization of current treatments for MG,MG exacerbations are associated with a high clinical and economic burden in both commercial and Medicare patients. Additional treatment options and improved disease management may help to reduce exacerbations and disease burden.

description:

This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on prescriptions provided to and filled by Medicare beneficiaries, including drug name, total number of prescriptions dispensed (including original prescriptions and refills) and total drug cost. The data covers calendar year 2013 and is based on final-action Part D claims for the entire Medicare Part D population. Information is redacted where necessary to protect beneficiary privacy.

The database is populated from the Medicare Part D Prescriber Public Use File (PUF). Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D claims, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physicians entire practice as it only includes information on beneficiaries enrolled in Medicare Part D prescription drug program. In addition, the data are not intended to indicate the quality of care provided. To review more information about the Part D Prescriber PUF, please refer to the Methodology document.

This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on prescriptions provided to and filled by Medicare beneficiaries, including drug name, total number of prescriptions dispensed (including original prescriptions and refills) and total drug cost. The data covers calendar year 2013 and is based on final-action Part D claims for the entire Medicare Part D population. Information is redacted where necessary to protect beneficiary privacy.

The database is populated from the Medicare Part D Prescriber Public Use File (PUF). Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D claims, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physicians entire practice as it only includes information on beneficiaries enrolled in Medicare Part D prescription drug program. In addition, the data are not intended to indicate the quality of care provided. To review more information about the Part D Prescriber PUF, please refer to the Methodology document.

United States Health Insurance: Claims Per Member Per Month: Medicare data was reported at 1,111.000 USD in 2023. This records an increase from the previous number of 1,012.000 USD for 2022. United States Health Insurance: Claims Per Member Per Month: Medicare data is updated yearly, averaging 791.000 USD from Dec 2007 (Median) to 2023, with 17 observations. The data reached an all-time high of 1,111.000 USD in 2023 and a record low of 746.230 USD in 2007. United States Health Insurance: Claims Per Member Per Month: Medicare data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG022: Health Insurance: Operations by Lines of Business.