The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan). 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 UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence

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.

The Part D Prescriber Public Use File (PUF) provides 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 CMSs 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 physicians 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.

The Medicare Part D Prescribers by Geography and Drug 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. For each 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.

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.

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.

The 2020 Medicare Part D Drug Cost and Utilization Dataset presents drug spending and utilization information on Medicare Part D drugs (drugs patients generally administer themselves) and includes annual data for 2016 to 2020.

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.

The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. 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 Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

The Medicare Part D Prescriber Public Use File provides information on prescription drug events (PDEs) incurred by Medicare beneficiaries with a Part D prescription drug plan for the year 2017. The Part D Prescriber PUF is organized by National Provider Identifier (NPI) and drug name and contains information on drug utilization (claim counts and day supply) and total drug costs.

Analysis of ‘Medicare Part D Spending by Drug’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/57f64f2c-fb36-42ea-a923-402a7e683f30 on 11 February 2022.

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

The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves.

The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. 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 Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

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

Analysis of ‘Medicare Part D Prescribers - by Geography and Drug’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/83ac5fae-afab-4de1-9f0e-f131f04377c2 on 11 February 2022.

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

The Medicare Part D Prescribers by Geography and Drug 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. For each 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.

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

CMS has released several information products that provide spending information for prescription drugs in the Medicare and Medicaid programs. The CMS Drug Spending Dashboards are online interactive tools that provide spending information for certain prescription drugs in the Medicare and Medicaid programs. CMS selected drugs for inclusion in the dashboards based on three criteria 1) drugs with high spending on a per user basis (Medicare Program) and drugs with high spending on a per prescription fill basis (Medicaid Program) 2) drugs with high total program spending and 3) drugs with high costs increases in recent years. The dashboard tools display relevant spending, utilization, and trend data and also include consumer-friendly information on the drug product descriptions, manufacturer(s), and uses. In addition to the Dashboards, CMS has released Medicare spending and utilization data for all Part B and Part D drugs. These summary data files were the basis for the Medicare Drug Spending Dashboard and include annual data for the most recent five years.

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.

The Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information files contain formulary, pharmacy network, and pricing 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 2023 Q4 to 2024 Q3 data. CMS will re-post the corrected data in batches between now and May 2025. These non-identifiable files are available on a quarterly 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. Pricing - Plan level average monthly costs for formulary Part D drugs (note: this table is only available in the quarterly files). 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 Monthly Prescription Drug Plan Formulary and Pharmacy Network Information is also available to access for the monthly 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 fourth quarter file of 2023. Year 2024 data continues to be available in the Q1-Q3 2024 files, then in the fourth quarter of 2024 year 2025 data becomes available. Estimated release dates for upcoming 2025 quarterly data (files reflect data for the quarter that ended the month before the file was released): 4/23/25 7/30/25 Files older than contract year 2019 can be purchased.

This data set contains details information on the prescription drugs that were prescribed by individual physicians in Utah and other health care providers in Utah and paid for under the Medicare Part D Prescription Drug Program in 2014.

The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the most significant improvement to senior health care in nearly 40 years. This overview page provides links to important information on the new benefit.

Content

More details about each file are in the individual file descriptions.

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 Hermes Rivera on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under the following licenses: NA, Public Domain

The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Part D Opioid Prescriber Summary File, which presents information on the individual opioid prescribing rates of health providers that participate in Medicare Part D program. This file is a prescriber-level data set that provides data on the number and percentage of prescription claims (includes new prescriptions and refills) for opioid drugs, and contains information on each provider’s name, specialty, state, and ZIP code. This summary file was derived from the 2016 Part D Prescriber Summary Table (Documentation available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Downloads/Prescriber_Methods.pdf)

The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Part D Opioid Prescriber Summary File, which presents information on the individual opioid prescribing rates of health providers that participate in Medicare Part D program. This file is a prescriber-level data set that provides data on the number and percentage of prescription claims (includes new prescriptions and refills) for opioid drugs, and contains information on each provider’s name, specialty, state, and ZIP code. This summary file was derived from the 2015 Part D Prescriber Summary Table (Documentation available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Downloads/Prescriber_Methods.pdf