Part D Prescriber National Summary Report, Calendar Year 2016

data.cms.gov | Last Updated 30 Nov 2018

The Part D Prescriber National Summary Report, Calendar Year 2016 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 National Summary Report 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). 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.

Tags: part d, national, summary, mpup, 2016

This dataset has the following 19 columns:

Column NameAPI Column NameData TypeDescriptionSample Values
Drug Namedrug_nametextThe name of the drug filled. This includes both brand names (for drugs that have a trademarked name) and generic names (for drugs that do not have a trademarked name).
Generic Namegeneric_nametextA term referring to the chemical ingredient of a drug rather than the trademarked brand name under which the drug is sold.
Number of Prescribersnumber_of_prescribersnumberThe total number of unique providers prescribing the drug. Prescriber counts fewer than 11 are suppressed and are indicated by a blank.
Number of Medicare Part D Claimsnumber_of_medicare_part_d_claimsnumberThe number of Medicare Part D claims. This includes original prescriptions and refills. Aggregated records based on claim counts fewer than 11 are not included in the data.
Number of Standardized 30-Day Part D Fillsnumber_of_standardized_30_day_part_d_fillsnumberThe number of Medicare Part D standardized 30-day fills. The standardized 30-day fill is derived from the number of days supplied on the Part D claim divided by 30. Standardized 30-day fill values less than 1.0 have been bottom-coded with a value of 1.0 and standardized 30-day fill values greater than 12.0 have been top-coded with a value of 12.0.
Aggregate Cost Paid for Part D Claimsaggregate_cost_paid_for_part_d_claimsnumberThe aggregate total drug cost paid for all associated claims. This amount includes ingredient cost, dispensing fee, sales tax, and any applicable vaccine administration fees. The total drug cost is based on the amounts paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers.
Number of Medicare Beneficiariesnumber_of_medicare_beneficiariesnumberThe total number of unique Medicare Part D beneficiaries with at least one claim for the drug. Beneficiary counts fewer than 11 are suppressed and are indicated by a blank.
GE65 Suppression Flagge65_suppression_flagtextThis flag indicates the reason that the Number of Medicare Part D Claims for Beneficiaries 65+, Number of Standardized 30-Day Part D Fills for Beneficiaries 65+, and Aggregate Cost Paid for Part D Claims for Beneficiaries 65+ are suppressed. An "*" indicates primary suppression due to Number of Medicare Part D Claims for Beneficiaries 65+ being between 1 and 10. A "#" indicates counter suppression because the "less than 65 group" (not explicitly displayed) contains a claim count between 1 and 10, which can be mathematically determined from the Number of Medicare Part D Claims and the Number of Medicare Part D Claims for Beneficiaries 65+.
Number of Medicare Part D Claims for Beneficiaries 65+number_of_medicare_part_d_claims_for_beneficiaries_65numberThe number of Medicare Part D claims for beneficiaries age 65 and older. This includes original prescriptions and refills. A blank indicates the value is suppressed. See GE65 Suppression Flag regarding suppression of data.
Number of Standardized 30-Day Part D Fills for Beneficiaries 65+number_of_standardized_30_day_part_d_fills_for_beneficiaries_65numberThe number of Medicare Part D standardized 30-day fills for beneficiaries age 65 and older. The standardized 30-day fill is derived from the number of days supplied on the Part D claim divided by 30. Standardized 30-day fill values less than 1.0 have been bottom-coded with a value of 1.0 and standardized 30-day fill values greater than 12.0 have been top-coded with a value of 12.0. If Number of Medicare Part D Claims for Beneficiaries 65+ is suppressed, this variable is suppressed. A blank indicates the value is suppressed. See GE65 Suppression Flag regarding suppression of data.
Aggregate Cost Paid for Part D Claims for Beneficiaries 65+aggregate_cost_paid_for_part_d_claims_for_beneficiaries_65numberThe aggregate total drug cost paid for all associated claims for beneficiaries age 65 and older. This amount includes ingredient cost, dispensing fee, sales tax, and any applicable vaccine administration fees. The total drug cost is based on the amounts paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers. If Number of Medicare Part D Claims for Beneficiaries 65+ is suppressed, this variable is suppressed. A blank indicates the value is suppressed. See GE65 Suppression Flag regarding suppression of data.
Beneficiary 65+ Suppression Flagbeneficiary_65_suppression_flagtextThis flag indicates the reason that the Number of Medicare Beneficiaries 65+ has been suppressed. An "*" indicates primary suppression due to Number of Medicare Beneficiaries 65+ being between 1 and 10. A "#" indicates counter suppression because the “less than 65 year old” group (not explicitly displayed) contains a beneficiary count between 1 and 10, which can be mathematically determined from Number of Medicare Beneficiaries and Number of Medicare Beneficiaries 65+.
Number of Medicare Beneficiaries 65+number_of_medicare_beneficiaries_65numberThe total number of unique Medicare Part D beneficiaries age 65 and older with at least one claim for the drug. A blank indicates the value is suppressed. See Beneficiary 65+ Suppression Flag regarding suppression of data.
Aggregate Cost Share for Beneficiaries with Low Income Subsidybene_cost_share_lisnumberThe aggregate total cost that beneficiaries using a drug, with a low-income subsidy, are responsible for paying during the year.
Aggregate Cost Share for Beneficiaries with No Low Income Subsidybene_cost_share_nolisnumberThe aggregate total cost that beneficiaries using a drug, with no low-income subsidy, are responsible for paying during the year.
Opioid Drug Flagopioid_drug_flagtextA flag indicating whether drugs in this Drug Name/ Generic Name combination are identified as an opioid drug. The list for opioids are based upon drugs included in the Medicare Part D Overutilization Monitoring System (OMS). The list originates from the Centers for Disease Control and Prevention. For additional information on Medicare Part D OMS visit: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/RxUtilization.html.
Long-Acting Opioid Drug Flagla_opioid_drug_flagtextA flag indicating whether drugs in this Drug Name/ Generic Name combination are identified as an long-acting opioid drug. The list for long-acting opioids are based upon drugs included in the Medicare Part D Overutilization Monitoring System (OMS). Those drugs were then identified by Drug Name/ Generic Name combinations as those that are formulated to release their medications over an extended period of time.
Antibiotic Drug Flagantibiotic_drug_flagtextA flag indicating whether drugs in this Drug Name/ Generic Name combination are identified as an antibiotic drug. The list for antibiotics was created by identifying antibiotic subcategories with the exclusion of the following types of products: tuberculosis agents, antimalarials, topical agents (topical ophthalmic, optic, vaginal, and dermatological agents, etc.).
Antipsychotic Drug Flagantipsychotic_drug_flagtextA flag indicating whether drugs in this Drug Name/ Generic Name combination are identified as an antipsychotic drug. The list for antipsychotics was created by identifying antipsychotic subcategories, including first and second generation antipsychotics, as well as antipsychotics included in combination with other drugs, (e.g., OLANZAPINE/FLUOXETINE HCL).