Centers for Medicare and Medicaid Services

You know when you hear that a drug costs $10,000 a month but Medicaid negotiated it down? This is the data behind those numbers. It shows every drug Medicaid paid for, broken down by state and quarter. You can see how many prescriptions were filled, how many pills or units that represents, and exactly what Medicaid paid. Compare it against what the drugs actually cost to acquire, and you can figure out what profit margin pharmacies made. It's the rare dataset that lets you see the actual economics of prescription drug reimbursement.

Every clinical lab in America that's certified to do tests has to report to CMS. This dataset is the official roster: where the labs are, what type they are (hospital lab, independent company, doctor's office, etc.), what kind of certification they have, and roughly how many tests they run each year. You get a snapshot once a year going back to 2016. Some labs in the file are no longer operating, their certificates got terminated, but they're still listed so you can see the history. If you want to know how many tests a particular type of lab was running in your state or county, or track whether the number of labs is growing or shrinking, this is where that number comes from.

What do pharmacies actually pay for the drugs they stock? This dataset tracks that. Every week, CMS updates pricing for millions of prescription and over-the-counter drugs, showing the per-unit cost for each one. It includes the generic version of each drug too, so you can compare what brand-name and generic alternatives cost to acquire. Useful for understanding drug pricing, comparing generic savings, or analyzing pharmacy costs.

States running Medicaid programs aren't allowed to pay pharmacies more than a certain amount for generic drugs. This dataset shows exactly what that limit is for every generic drug, broken down by month. The limit is set by the federal government at 175% of what manufacturers actually sell them for on average. If you run a pharmacy and take Medicaid, this is what you'll get reimbursed. If you study healthcare costs or policy, this shows how the government caps what it pays for generics.

When Medicaid buys drugs, manufacturers have to give back a portion of the price to states. This is that list. It includes what drug it is (by its official code), who makes it, when the FDA approved it, and which category it falls into (new drug, generic, etc.). That category determines how much money has to go back. If you're researching pharmaceutical pricing, Medicaid costs, or want to know if a specific drug participates in the program, this is where you look.

This is the actual count of people covered by Medicare each month, split every way CMS can track it. You can see how many beneficiaries are in your county or state, how that's shifted over time, and who they are by age, race, disability status, and whether they also qualify for Medicaid. It covers both Original Medicare and Medicare Advantage, and shows how many people have different combinations of benefits. The data goes back to 2013 and updates monthly.