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Care", "claims": 41, "drug_cost_usd": 840 }, { "specialty": "Exclusive Provider Organization", "claims": 40, "drug_cost_usd": 175 }, { "specialty": "Midwife, Lay", "claims": 31, "drug_cost_usd": 302 }, { "specialty": "Dental Therapist", "claims": 30, "drug_cost_usd": 50 }, { "specialty": "Electrodiagnostic Medicine", "claims": 30, "drug_cost_usd": 756 }, { "specialty": "Technician, Health Information", "claims": 26, "drug_cost_usd": 357 }, { "specialty": "Massage Therapist", "claims": 25, "drug_cost_usd": 24 }, { "specialty": "Phlebology", "claims": 13, "drug_cost_usd": 80 }, { "specialty": "Eyewear Supplier", "claims": 12, "drug_cost_usd": 144 }, { "specialty": "Home Health", "claims": 12, "drug_cost_usd": 294 }, { "specialty": "Physical Therapy Assistant", "claims": 12, "drug_cost_usd": 91 }, { "specialty": "Radiation Therapy Center", "claims": 12, "drug_cost_usd": 559 }, { "specialty": "Chore Provider", "claims": 11, "drug_cost_usd": 31 } ] }, { "id": "by_state", "label": "Claims and cost by prescriber state", "columns": [ "state", "claims", "drug_cost_usd" ], "rows": [ { "state": "CA", "claims": 129565592, "drug_cost_usd": 21262400165 }, { "state": "FL", "claims": 113582265, "drug_cost_usd": 16838937918 }, { "state": "TX", "claims": 98638359, "drug_cost_usd": 15746441934 }, { "state": "NY", "claims": 95240368, "drug_cost_usd": 18174131281 }, { "state": "PA", "claims": 72980145, "drug_cost_usd": 11128347140 }, { "state": "OH", "claims": 62294899, "drug_cost_usd": 9043071424 }, { "state": "NC", "claims": 52430568, "drug_cost_usd": 8138215348 }, { "state": "IL", "claims": 51867241, "drug_cost_usd": 7536982736 }, { "state": "MI", "claims": 49623865, "drug_cost_usd": 7821347989 }, { "state": "GA", "claims": 47568589, "drug_cost_usd": 7304129570 }, { "state": "TN", "claims": 38950358, "drug_cost_usd": 5659749785 }, { "state": "NJ", "claims": 36124998, "drug_cost_usd": 6263635160 }, { "state": "MO", "claims": 35463463, "drug_cost_usd": 4833468353 }, { "state": "IN", "claims": 35193853, "drug_cost_usd": 5190809669 }, { "state": "MA", "claims": 32361931, "drug_cost_usd": 5922202143 }, { "state": "VA", "claims": 31922467, "drug_cost_usd": 4685929476 }, { "state": "KY", "claims": 29539412, "drug_cost_usd": 3992210902 }, { "state": "AL", "claims": 29065240, "drug_cost_usd": 4397971083 }, { "state": "PR", "claims": 28752106, "drug_cost_usd": 2641232871 }, { "state": "WI", "claims": 27394211, "drug_cost_usd": 3840695530 }, { "state": "LA", "claims": 26733751, "drug_cost_usd": 3909690765 }, { "state": "SC", "claims": 26346501, "drug_cost_usd": 4166797794 }, { "state": "AZ", "claims": 25708782, "drug_cost_usd": 4104362870 }, { "state": "WA", "claims": 24783752, "drug_cost_usd": 3562222029 }, { "state": "MN", "claims": 23094567, "drug_cost_usd": 3286593997 }, { "state": "MD", "claims": 19675615, "drug_cost_usd": 3420670237 }, { "state": "OK", "claims": 18322879, "drug_cost_usd": 2667189115 }, { "state": "AR", "claims": 18241272, "drug_cost_usd": 2169438737 }, { "state": "CT", "claims": 17035961, "drug_cost_usd": 3244608255 }, { "state": "MS", "claims": 16922230, "drug_cost_usd": 2244482966 }, { "state": "CO", "claims": 16573710, "drug_cost_usd": 2737455389 }, { "state": "IA", "claims": 16509676, "drug_cost_usd": 1964928631 }, { "state": "OR", "claims": 16099092, "drug_cost_usd": 2292723350 }, { "state": "KS", "claims": 14430363, "drug_cost_usd": 1876455871 }, { "state": "WV", "claims": 11351963, "drug_cost_usd": 1496997308 }, { "state": "NV", "claims": 9980111, "drug_cost_usd": 1554229839 }, { "state": "NE", "claims": 9542119, "drug_cost_usd": 1273191618 }, { "state": "UT", "claims": 8683564, "drug_cost_usd": 1243336040 }, { "state": "ID", "claims": 7048626, "drug_cost_usd": 991203715 }, { "state": "NM", "claims": 6903978, "drug_cost_usd": 947085835 }, { "state": "ME", "claims": 6630454, "drug_cost_usd": 1080557534 }, { "state": "NH", "claims": 5823419, "drug_cost_usd": 851255911 }, { "state": "RI", "claims": 5643841, "drug_cost_usd": 753138286 }, { "state": "DE", "claims": 4469302, "drug_cost_usd": 734247072 }, { "state": "MT", "claims": 4467425, "drug_cost_usd": 525099676 }, { "state": "SD", "claims": 4301083, "drug_cost_usd": 549489221 }, { "state": "HI", "claims": 3818948, "drug_cost_usd": 780970047 }, { "state": "ND", "claims": 3786445, "drug_cost_usd": 412252334 }, { "state": "VT", "claims": 2571367, "drug_cost_usd": 416696788 }, { "state": "DC", "claims": 1896979, "drug_cost_usd": 553407537 }, { "state": "WY", "claims": 1785327, "drug_cost_usd": 189691986 }, { "state": "AK", "claims": 1471084, "drug_cost_usd": 265514493 }, { "state": "VI", "claims": 170840, "drug_cost_usd": 28807658 }, { "state": "GU", "claims": 85921, "drug_cost_usd": 6477420 }, { "state": "ZZ", "claims": 42837, "drug_cost_usd": 3877351 }, { "state": "XX", "claims": 39868, "drug_cost_usd": 7119316 }, { "state": "AE", "claims": 31023, "drug_cost_usd": 1541925 }, { "state": "AP", "claims": 28641, "drug_cost_usd": 4171280 }, { "state": "MP", "claims": 13045, "drug_cost_usd": 944327 }, { "state": "AA", "claims": 2503, "drug_cost_usd": 67105 }, { "state": "FM", "claims": 13, "drug_cost_usd": 26 } ] } ], "limitations": [ "Gross cost, not net. These dollars are before confidential manufacturer rebates, which are largest for brand drugs; the rankings hold, the absolute totals overstate net spending.", "One data year, Medicare only. Part D covers Medicare beneficiaries — mostly people 65+ or with disabilities — not the whole U.S. population, so 'most-prescribed' means most-prescribed to seniors.", "Small-volume suppression. CMS removes any prescriber-drug row with fewer than 11 claims before publishing and suppresses beneficiary counts under 11, so totals slightly understate the true universe.", "Brand vs generic is inferred. The file carries no explicit flag; it is inferred from whether the brand and generic names match, the standard CMS approach. Authorized generics and combination products can land on the other side of the line.", "Drug rankings group on the published brand-name and generic-name pair, so a molecule sold under several brands appears as several rows.", "Aggregate-only, no quality claim. Fonteum does not name, rank, or rate any prescriber here, and prescribing volume is not a measure of care quality." ], "reproducible_sql": "-- Headline: claims + cost, generic vs brand (one pass)\nSELECT\n count(*) AS rows,\n sum(total_claims) AS claims,\n round(sum(total_drug_cost)) AS drug_cost,\n sum(total_claims) FILTER (WHERE lower(brand_name)=lower(generic_name)) AS generic_claims,\n round(sum(total_drug_cost) FILTER\n (WHERE lower(brand_name)=lower(generic_name))) AS generic_cost\nFROM cms_part_d_prescribers\nWHERE data_year = 2024;\n\n-- Most-prescribed drugs (top 25 by claims)\nSELECT brand_name, generic_name,\n sum(total_claims) AS claims,\n round(sum(total_drug_cost)) AS cost\nFROM cms_part_d_prescribers\nWHERE data_year = 2024\nGROUP BY brand_name, generic_name\nORDER BY claims DESC\nLIMIT 25;\n\n-- Costliest drugs (top 25 by drug cost)\nSELECT brand_name, generic_name,\n sum(total_claims) AS claims,\n round(sum(total_drug_cost)) AS cost\nFROM cms_part_d_prescribers\nWHERE data_year = 2024\nGROUP BY brand_name, generic_name\nORDER BY cost DESC\nLIMIT 25;", "license": "U.S. Government Works (17 U.S.C. §105)", "generated_by": "Fonteum — https://fonteum.com", "notes": "Aggregate, source-traced figures frozen to the as-of date above. Re-derive by running the published query against the named source file; no per-person records are included." }