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 Durable Medical Equipment, Devices & Supplies by Referring Provider and Service dataset contains information on usage, payments and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and supplier rental indicator.

 

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 Provider and Supplier Taxonomy Crosswalk dataset lists the providers and suppliers eligible to enroll in Medicare programs with the proper healthcare provider taxonomy code. This data includes the Medicare speciality codes, if available, provider/supplier type description, taxonomy code, and the taxonomy description.

The Medicare Durable Medical Equipment, Devices & Supplies by Referring Provider dataset contains information on usage, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI).

The Restructured BETOS Classification System (RBCS) dataset is a taxonomy that allows researchers to group healthcare service codes for Medicare Part B services (i.e., HCPCS codes) into clinically meaningful categories and subcategories. It is based on the original Berenson-Eggers Type of Service (BETOS) classification created in the 1980s, and includes notable updates such as Part B non-physician services. The RBCS will undergo annual updates by a technical expert panel of researchers and clinicians.

The CMS Program Statistics - Medicare Physician, Non-Physician Practitioner and Supplier tables provide use and payment data for physicians, other practitioners, limited-licensed practitioners, and durable medical equipment, prosthetic, and orthotic (DMEPOS) suppliers. 

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 PHYSSUPP 1.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR PHYSSUPP 2.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR PHYSSUPP 3.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, Cost Sharing, and Balance Billing for Original Medicare Beneficiaries, by Area of Residence
MDCR PHYSSUPP 4.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Type of Service
MDCR PHYSSUPP 5.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Place of Service
MDCR PHYSSUPP 6.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization, Program Payments, and Balance Billing for Original Medicare Beneficiaries, by Physician Specialty
MDCR PHYSSUPP 7.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization and Program Payments for Original Medicare Beneficiaries, by Berenson-Eggers Type of Service (BETOS) Classification

The Medicare Durable Medical Equipment, Devices & Supplies by Supplier and Service dataset contains information on usage, payments and submitted charges organized by supplier National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and supplier rental indicator.

 

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 Durable Medical Equipment, Devices & Supplies by Supplier dataset contains information on usage, payments, submitted charges and beneficiary demographic and health characteristics organized by supplier National Provider Identifier (NPI).

The CMS Program Statistics – Medicare Advantage, Physician, Non-Physician Practitioner and Supplier tables provide utilization data for physician, non-physician practitioners, and suppliers, by Medicare Advantage beneficiaries.

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 PHYSSUPP MA 1.  Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Type of Entitlement, Yearly Trend
MDCR PHYSSUPP MA 2.  Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status
MDCR PHYSSUPP MA 3.  Medicare Physicians, Non-Physician Practitioners, and Suppliers: Utilization for Medicare Advantage Beneficiaries, by Area of Residence
MDCR PHYSSUPP MA 4.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization for Medicare Advantage Beneficiaries, by Place of Service
MDCR PHYSSUPP MA 5.  Medicare Physicians, Non-Physician Practitioners, and Suppliers:  Utilization for Medicare Advantage Beneficiaries, by Restructured BETOS Classification System