Stores Management Information about Medicare Part C & Part D data for premiums and Medicare Part D Prescription Drug Subsidy processing, and workload management data.

근로복지공단에서 제공하는 지사별 약제비 지급 현황(청구건수, 청구액, 지급 건 등)입니다. (2019년~2022년)

Stores Medicare Part C & Part D data for premiums and Medicare Part D Prescription Drug Subsidy processing.

The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan). For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence

The CMS Program Statistics - Medicare Part D tables provide use and Part D drug costs by type of Part D plan (stand-alone prescription drug plan and Medicare Advantage prescription drug plan). For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR UTLZN D 1. Medicare Part D Utilization: Average Annual Prescription Drug Fills by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Generic Dispensing Rate, Yearly Trend MDCR UTLZN D 2. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 3. Medicare Part D Utilization: Average Annual Gross Drug Costs Per Part D Enrollee, by Type of Plan, Low Income Subsidy (LIS) Eligibility, and Brand/Generic Drug Classification, Yearly Trend MDCR UTLZN D 4. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan and Demographic Characteristics MDCR UTLZN D 5. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan and Demographic Characteristics MDCR UTLZN D 6. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Enrollee, by Type of Plan, by Area of Residence MDCR UTLZN D 7. Medicare Part D Utilization: Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Type of Plan, by Area of Residence MDCR UTLZN D 8. Medicare Part D Utilization: Number of Part D Utilizers and Average Annual Prescription Drug Fills by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 9. Medicare Part D Utilization: Number of Part D Utilizers and Drug Costs by Type of Part D Plan, Low Income Subsidy (LIS) Eligibility, and Part D Coverage Phase, Yearly Trend MDCR UTLZN D 10. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Events (Fills) and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Demographic Characteristics MDCR UTLZN D 11. Medicare Part D Utilization: Number of Part D Utilizers, Average Annual Prescription Drug Fills and Average Annual Gross Drug Cost Per Part D Utilizer, by Part D Coverage Phase and Area of Residence

The Monthly Prescription Drug Plan Formulary and Pharmacy Network Information files contain formulary and pharmacy network data for Medicare Prescription Drug Plans and Medicare Advantage (MA) Prescription Drug Plans (with the exception of employer and Program of All-Inclusive Care for the Elderly plans). Notice: CMS has identified an issue that resulted in a 15% coinsurance for plans with Defined Standard benefits to be listed rather than a 25% coinsurance in the Beneficiary Cost File under certain scenarios. This issue affected the October 2023 to November 2024 data. CMS will re-post the corrected data in batches between now and May 2025. The following files have already been corrected and re-posted: October 2024 November 2024 These non-identifiable files are available on a monthly basis and are comprised of the following tables: Plan Information - Information such as plan name, contract ID, plan ID, service area, and plan type. Geographic Locator - MA and Prescription Drug Plans region codes and county codes. Basic Drugs Formulary - Formulary details for each plan including National Drug Codes (NDCs), cost share tier level, and indicators for step therapy, quantity limits, and prior authorization. Excluded Drugs Formulary - Enhanced alternative plans may elect to provide a supplemental benefit and cover excluded drugs. File includes formulary details for excluded drugs that are covered by the plan (for enhanced alternative plans only). Beneficiary Cost - Plan level cost sharing details for preferred, non-preferred, and mail order network pharmacies. Pharmacy Network - National Provider Identifier (NPI) numbers for each network pharmacy including preferred, retail, and mail order indicators. Indication Based Coverage Formulary File - Includes drugs covered based on FDA-approved indication for each plan. Insulin Beneficiary Cost File - Plan level cost sharing details for insulin at preferred, non-preferred and mail order network pharmacies. These are large files and can take time to download. Please read the “Agreement for Use” in the Resources section below. This document contains important information regarding timeframes for obtaining data as well as data accuracy and integrity. The Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information is also available to access for the quarterly level information. Please note: The Part D benefit year information for plans become available in October of the year prior. For example, year 2024 data is available in the October, November and December 2023 monthly files. Year 2024 data continues to be available in the January through September 2024 monthly files, then beginning in October of 2024 year 2025 data becomes available. Estimated release dates for upcoming 2025 monthly data (files reflect data for the month in which the file is released): 2/26/25 3/26/25 4/23/25 5/21/25 6/18/25 7/30/25 8/27/25 9/24/25 Files older than contract year 2019 can be purchased.

The Monthly Prescription Drug Plan Formulary and Pharmacy Network Information files contain formulary and pharmacy network data for Medicare Prescription Drug Plans and Medicare Advantage (MA) Prescription Drug Plans (with the exception of employer and Program of All-Inclusive Care for the Elderly plans). These non-identifiable files are available on a monthly basis and are comprised of the following tables: Plan Information - Information such as plan name, contract ID, plan ID, service area, and plan type. Geographic Locator - MA and Prescription Drug Plans region codes and county codes. Basic Drugs Formulary - Formulary details for each plan including National Drug Codes (NDCs), cost share tier level, and indicators for step therapy, quantity limits, and prior authorization. Excluded Drugs Formulary - Enhanced alternative plans may elect to provide a supplemental benefit and cover excluded drugs. File includes formulary details for excluded drugs that are covered by the plan (for enhanced alternative plans only). Beneficiary Cost - Plan level cost sharing details for preferred, non-preferred, and mail order network pharmacies. Pharmacy Network - National Provider Identifier (NPI) numbers for each network pharmacy including preferred, retail, and mail order indicators. Indication Based Coverage Formulary File - Includes drugs covered based on FDA-approved indication for each plan. Insulin Beneficiary Cost File - Plan level cost sharing details for insulin at preferred, non-preferred and mail order network pharmacies. These are large files and can take time to download. Please read the “Agreement for Use” in the Resources section below. This document contains important information regarding timeframes for obtaining data as well as data accuracy and integrity. The Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information is also available to access for the quarterly level information. Please note: The Part D benefit year information for plans become available in October of the year prior. For example, year 2024 data is available in the October, November and December 2023 monthly files. Year 2024 data continues to be available in the January through September 2024 monthly files, then beginning in October of 2024 year 2025 data becomes available. Estimated release dates for upcoming 2025 and 2026 monthly data (files reflect data for the month in which the file is released): 10/15/25 11/19/25 12/17/25 1/28/26 2/25/26 3/25/26 4/22/26 5/20/26 6/17/26 7/29/26 8/26/26 9/23/26 Files older than contract year 2019 can be purchased.

Contains Title II and Medicare Data. Specifically data relating to Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D.

The CMS Program Statistics - Medicare Premium tables provide information on counts of Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) total premium, standard base premium, reduced base premium, and penalty beneficiaries. In addition, these tables include premium amounts and penalty amounts. For the Part B premium tables, information on Income Related Monthly Adjustment Amount (IRMAA) beneficiaries, IRMAA amounts, Managed Care Reduction beneficiaries and Managed Care Reduction amounts are also included. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. Below is the list of tables: MDCR PREMIUMS 1. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts, Yearly Trend MDCR PREMIUMS 2. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PREMIUMS 3. Medicare Premiums: Medicare Part A Premium Beneficiaries and Amounts, by Area of Residence MDCR PREMIUMS 4. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts, Yearly Trend MDCR PREMIUMS 5. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR PREMIUMS 6. Medicare Premiums: Medicare Part B Premium Beneficiaries and Amounts, by Area of Residence