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Medicare - Outpatient
Dataset
CPT copyright 2016 American Medical Association. All Rights Reserved.
The Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 60 C-APC Groups and their primary HCPCS paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2017. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
Tags outpatient national 2017 hcpcs apc
API Docs
Created
August 14 2019
Views
1,310

Medicare - Outpatient
Dataset
The Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 60 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2017. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
Tags national 2017 mpup outpatient
API Docs
Created
August 14 2019
Views
758

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.
Tags mpup national 2017 drg inpatient
API Docs
Created
August 7 2019
Views
3,416

Medicare - Durable Medical Equipment (DME)
Dataset
The 2017 Referring Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) National Aggregate table presents information on DMEPOS products and services provided to Medicare beneficiaries ordered by physicians and other healthcare professionals. The data in the Referring Provider DMEPOS PUF covers calendar year 2017 and contains final-action (i.e., all claim adjustments have been resolved) Part B non-institutional DMEPOS line items for the Medicare fee-for-service (FFS) population.
Tags national 2017 hcpcs dmepos mpup
API Docs
Created
May 22 2019
Views
856

Medicare - Part D
Dataset
The Part D Prescriber National Summary Report, Calendar Year 2017 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 2017 mpup summary national part d
API Docs
Created
March 6 2019
Views
2,470

Medicare - Outpatient
Dataset
CPT copyright 2015 American Medical Association. All Rights Reserved.
The Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 35 C-APC Groups and their primary HCPCS paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2016. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
Tags outpatient apc hcpcs national 2016 and 1 more
API Docs
Created
January 31 2019
Views
1,014

Medicare - Outpatient
Dataset
CPT copyright 2014 American Medical Association. All Rights Reserved.
The Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 25 C-APC Groups and their primary HCPCS paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2015. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
Tags national 2015 outpatient mpup apc and 1 more
API Docs
Created
January 31 2019
Views
316

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.
Tags 2016 mpup national summary drg and 1 more
API Docs
Created
July 19 2018
Views
7,374

Medicare - Durable Medical Equipment (DME)
Dataset
The 2016 Referring Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) National Aggregate table presents information on DMEPOS products and services provided to Medicare beneficiaries ordered by physicians and other healthcare professionals. The data in the Referring Provider DMEPOS PUF covers calendar year 2016 and contains final-action (i.e., all claim adjustments have been resolved) Part B non-institutional DMEPOS line items for the Medicare fee-for-service (FFS) population.
Tags national 2016 hcpcs dmepos mpup
API Docs
Created
May 8 2018
Views
1,419

Medicare - Part D
Dataset
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 2016 mpup summary national part d
API Docs
Created
March 22 2018
Views
3,389

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011.
Tags mpup national summary drg inpatient
API Docs
Created
October 31 2017
Views
1,058

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2012.
Tags mpup national summary drg inpatient
API Docs
Created
October 31 2017
Views
1,343

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2013.
Tags mpup national summary drg inpatient
API Docs
Created
October 31 2017
Views
663

Medicare - Inpatient
Dataset
The Inpatient Utilization and Payment national summary data provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.
Tags mpup national summary drg inpatient
API Docs
Created
October 31 2017
Views
2,198

Medicare - Outpatient
Dataset
The Outpatient Utilization and Payment national summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2011. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Tags national outpatient 2011 mpup
API Docs
Created
October 31 2017
Views
304

Medicare - Outpatient
Dataset
The Outpatient Utilization and Payment national summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2012. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Tags national outpatient 2012 mpup
API Docs
Created
October 31 2017
Views
237

Medicare - Outpatient
Dataset
The Outpatient Utilization and Payment national summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2013. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Tags national outpatient 2013 mpup
API Docs
Created
October 31 2017
Views
191

Medicare - Outpatient
Dataset
The Outpatient Utilization and Payment national summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 32 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2014. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Tags national outpatient 2014 mpup
API Docs
Created
October 31 2017
Views
372

Medicare - Part D
Dataset
The Part D Prescriber National Summary Report, Calendar Year 2013 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.
Tags mpup summary national part d
API Docs
Created
October 12 2017
Views
943

Medicare - Part D
Dataset
The Part D Prescriber National Summary Report, Calendar Year 2014 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.
Tags mpup summary national part d
API Docs
Created
October 12 2017
Views
955
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