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Medicare Provider Utilization and Payment Data Part D Prescriber

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Dataset logo

Medicare Provider Utilization and Payment Data Part D Prescriber

By CMS

Information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program from 2013 to 2017

Type

Dataset

Update frequency

Historical

Updated

Apr 18, 2019

Delivery method

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The Part D Prescriber Public Use File (PUF) dataset by the Centers for Medicare & Medicaid Services (CMS) 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.

It 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.

The dataset has limitations as 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.

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