Part D Prescriber Data CY 2016
Guidance for the CY 2016 Part D Prescriber Public Use File (PUF) which 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.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 27, 2019
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 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 available below.
Data are available in two formats:
- An online interactive dataset (allows users to sort and filter data directly without downloading).
- Tab delimited file format (requires importing into database or statistical software; SAS® read-in language is included in the download ZIP package)
CMS has also created three types of summary tables: 1) a prescriber level summary, 2) a drug level-summary at the national level, and 3) a drug level-summary at the state level. A detailed methodology document can be found in the Downloads section below which contains important information regarding the limitations of data usage.
11/15/18 UPDATE:
We have updated the Part D Prescriber PUF data tables with new long-acting opioid information to replace the previously reported extended release opioid information. These enhancements are described in detail within the Updates section of the Part D Prescriber PUF Methodology(PDF) (PDF).
Detailed Data:
Interactive Dataset: Part D Prescriber PUF NPI Drug, CY2016, Interactive Dataset
Downloadable Tab Delimited Format: Part D Prescriber PUF NPI Drug, CY2016, (Tab Delimited Format) [566MB]
[Note: This Compressed ZIP package contains the tab delimited data file which is 3.0 GB uncompressed and contains more than 24 million records, thus importing this file into Microsoft Excel will result in an incomplete loading of data. Use of database or statistical software is required; a SAS® read-in statement is supplied.]
Provider Summary Table:
Interactive Dataset: Part D Prescriber Summary table, CY2016, Interactive Dataset
Downloadable Tab Delimited Format: Part D Prescriber Summary table, CY2016, (Tab Delimited Format) [140MB]
[Note: This Compressed ZIP package contains the tab delimited data file which is 333 MB uncompressed and contains more than 1 million records, thus importing this file into Microsoft Excel will result in an incomplete loading of data. Use of database or statistical software is required; a SAS® read-in statement is supplied.]
Drug Category Lists: Part D Prescriber Summary, CY2016, Drug Category List, Microsoft Excel (xlsx) (ZIP)
Drug Summary Tables:
Interactive Dataset: Part D Drug National Summary table, CY2016, Interactive Dataset
Downloadable Excel: Part D Drug National Summary table, CY2016, Microsoft Excel (.xlsx)
Interactive Dataset: Part D Drug State Summary table, CY2016, Interactive Dataset
Downloadable Excel: Part D Drug State Summary table, CY2016, Microsoft Excel (.xlsx)
Inquiries regarding this data can be sent to MedicareProviderData@cms.hhs.gov.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.