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CMS Part D Spending

CMS Medicare Part D Spending by Drug

Centers for Medicare & Medicaid Services (CMS) · Tier-1 · research-only (never on individual profiles)

Research-only

The CMS Medicare Part D Spending by Drug file reports per-drug Part D spending — total spend, claims, beneficiaries, dosage units, average spend, a high-spend outlier flag, and year-over-year change — by brand, generic, and manufacturer. It is drug-keyed and carries no provider identifier; the 'Overall' manufacturer row is the aggregate across all manufacturers of a drug.

What Fonteum uses it for

How this source shows up on Fonteum.

Tier-1 drug-level Medicare Part D spending reference for /data and /research pages, keyed on brand × generic × manufacturer. The read API resolves on the brand name. There is no NPI and no entity-graph linkage.

What this source does NOT mean

Part D spending describes drug-level program cost — it is not a statement about any prescriber or provider, not a clinical recommendation, and a high-spend drug is not a Fonteum judgment about the drug or its manufacturer.

What this dataset answers

Research and data questions this source supports.

  • Pull total Medicare Part D spending, claims, and beneficiaries for a drug by brand, generic, and manufacturer.
  • Build a drug-cost trend view using the year-over-year change in average spend per dosage unit.
  • Identify high-spend outlier drugs for a prescription-cost research study.
  • Cross-reference Part D spending against Drugs@FDA approvals and the NDC directory by manufacturer.

Dataset size: 14,309 drug × manufacturer rows (2026-06-14 snapshot)

Fields used

Per-field display contract.

Fields listed below show their configured `display_allowed` flag from the §94 provenance schema. Fields marked write-locked are captured for audit and are not rendered on profile pages.

Research-only — never on profiles

8 fields
brand_nameBrand name
generic_nameGeneric name
manufacturer_nameManufacturer (or 'Overall' aggregate)
data_yearData year
total_spendingTotal Part D spending (USD)
total_claimsTotal claims
total_beneficiariesTotal beneficiaries
change_avg_spend_per_dosage_unitYoY change in avg spend per dosage unit
Limitations

What we can’t infer from this source.

  • Drug-keyed (brand + generic + manufacturer) — there is no provider NPI and no entity-graph linkage.
  • Tier-1 — aggregate research context only; never rendered on individual provider profiles.
  • Fonteum holds the latest published data year; the file lags the calendar year.
  • Spending is a program-cost fact, not a quality or appropriateness measure of the drug or manufacturer.
Source metadata

Authority, license, publisher cadence.

Authority

Centers for Medicare & Medicaid Services (CMS)

Tier

Tier-1 · research-only (never on individual profiles)

Publisher / configured cadence

Declared or configured cadence: Annual — CMS republishes the Part D Spending by Drug file under a fresh release-dated path. Not evidence of the latest loaded source date.

License

U.S. government public-domain works. Free to use with attribution; explicit redistribution rights. License ↗

Attribution requirement

Source: Centers for Medicare & Medicaid Services (CMS) — Medicare Part D Spending by Drug · Data Year {YYYY}

ToS & usage notes

What the source allows.

U.S. government public-domain works. CMS publishes the Medicare Part D Spending by Drug file as a no-auth bulk CSV at data.cms.gov with explicit redistribution rights. Snapshot and attestation fields must be read from the specific artifact; no provenance fact currently links deterministically to a signature.

Sample provenance

What a single field looks like in the graph.

This worked example shows the provenance shape used when a surfaced field has populated source, last-checked, display-rule, and confidence metadata. Individual fields may omit unavailable values.

Field

Per-drug Part D spending (research-only)

Sample value

Example Brand · Overall · 2023 · total spending $12.5M · 84,000 beneficiaries

Provenance line

Source: CMS Medicare Part D Spending by Drug · Data Year 2023 · Methodology cms-part-d-spending/v1 · Display rule: drug-keyed — renders on dataset + research pages, no provider linkage

How to access

Official API, bulk download, and Fonteum endpoints.

Frequently asked

Common questions about CMS Part D Spending.

What is the CMS Medicare Part D Spending by Drug file?
It reports per-drug Medicare Part D spending — total spend, claims, beneficiaries, dosage units, average spend, a high-spend outlier flag, and year-over-year change — by brand, generic, and manufacturer. The 'Overall' manufacturer row is the aggregate across all manufacturers of a drug.
Is this linked to prescribers?
No. The file is drug-keyed (brand + generic + manufacturer) and carries no provider identifier — there is no NPI and no entity-graph linkage. The read API resolves on the brand name.
Which data year is covered?
Fonteum holds the latest published data year (2023 in the current snapshot). As of the 2026-06-14 snapshot, the table holds 14,309 drug × manufacturer rows.
Where is the data published and is it free?
CMS publishes the file annually at data.cms.gov as a no-auth bulk CSV. It is U.S. government public-domain data — free to download and redistribute with attribution. Fonteum resolves the live CSV by the stable dataset UUID and attests each snapshot.
Does high spending mean a drug is overpriced?
No. Spending is a program-cost fact driven by price and volume together. It is not a quality or appropriateness measure of the drug or manufacturer, and it is not a Fonteum judgment.
Related

Related sources in the graph

See also
  • /sources → The generated source-catalog subset — documented datasets Fonteum cites.
  • /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
  • /methodology → Documented sourcing, publisher cadence, observed freshness, and corrections policy.
  • /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.

What’s on file, by the numbers

Platform snapshot · 2026-08-11

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
90sources with dataDistinct snapshot source IDs with at least one positive record count
73fresh sourcesDistinct source IDs whose latest positive-data snapshot falls within the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Integrated, with-data, and fresh-observation counts are separate. No platform-wide source-completeness count is published. Completeness is source-specific and must be evaluated against the named source's expected scope. State coverage is a separate jurisdiction measure.

Source authority is record-specific

Use the issuer named on the record.

Fonteum spans federal, state, and global public publishers. A source page or returned record identifies its issuer and dataset where that metadata is available. A platform registry count does not assign every page to one authority or establish loaded, fresh, or complete coverage.

Browse source records and their stated limitations →

Reproducible by design

Inspect the evidence each published figure actually supplies.

Source and date

Research pages expose the named public file and observation date where those fields are available. Source-file SHA-256 coverage is separate; facts do not currently link deterministically to signatures.

Available derivation

Studies with a retained release and committed derivation link the SQL or method used. Other studies state the evidence and reproduction limits they actually have.

Daily observations

Dated table row-count observations can detect local drift. They do not imply that an upstream publisher released or Fonteum ingested new data that day.

Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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