Medicare Part D Data
What Medicare Part D data were released about me?
The Medicare Part D Prescriber Public Use File includes information on the prescription drugs that individual physicians prescribed in 2013 under the Medicare Part D Prescription Drug Program.
Data are available on the CMS website in the following formats:
- Tab delimited file (requires statistical software for analysis)
- MS Excel tables split by provider last name
- Summary tables (a prescriber level summary and a drug level-summary at the national and state levels)
- What can I do when I encounter a discrepancy?
Send inquiries regarding this data to MedicareProviderData@cms.hhs.gov.
- What information was released about neurologists’ prescribing patterns?
Data identifies providers using their National Provider Identifier (NPI) and the specific prescriptions dispensed on their behalf, listed by brand name (if applicable) and generic name. Per each provider and drug, the data included the total number of dispensed prescriptions (original prescriptions and refills) and the total drug costs. In order to protect beneficiary privacy, CMS did not include information in cases where 10 or fewer prescriptions were dispensed.
Neurology was one of the top 5 prescriber specialties with the highest total drug costs and the highest cost per claim, reflecting the high-cost treatments used by neurology namely for Multiple Sclerosis drugs. At the same time, neurologists had one of the highest generic dispensing rates among other specialties.
- What are some common limitations of the data?
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, 36 million people).
The data are not intended to indicate the quality of provided care.
The data in this file are limited to medications covered by the Part D program and those drugs excluded by the Part D program but covered by individual Part D prescription drug plans through supplemental benefits.
The data does not include over-the-counter medications or any prescriptions obtained outside the Part D benefit.
- With these limitations should we use this data file at all?
This new dataset provides key information to consumers, providers, researchers, and other stakeholders to help drive transformation of the health care delivery system. This data enables a wide range of analyses on the type of prescription drugs prescribed in the Medicare Part D program, and on prescription drug utilization and spending generally. The new dataset can be used to examine the relative rank of drugs by utilization and costs.