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Data_Cost.html

Updated 3/29/2018

QE Medicare Data Cost Estimates



Qualified Entities (QEs) are eligible to receive extracts of Medicare Parts A and B claims data and Part D prescription drug event data under the Qualified Entity program. Extracts of Parts A and B claims data are available as quarterly or annual files and extracts of Part D prescription drug event data are available only as annual files.

The first table below provides an overview of the QE Medicare data file cost structure. The cost of the data files is based on the number of beneficiaries included in the data extract (see the second table below for information on the number of Medicare beneficiaries in each state). The amounts shown in the tables are per extract. For files available on a quarterly basis, the amount shown below will be charged per quarter. QEs will receive a final cost estimate after they receive their Phase 2 (Data Security) certification and DUA approval.

Depending on their other sources of claims data and reporting region, QEs are eligible to receive regional data sets (county cohorts), state-segmented data sets, or a national file (all 50 states and the District of Columbia). QEs that applied as Qualified Clinical Data Registries (QCDR) will receive data extracts based on the providers affiliated with that QCDR. Additionally, a 5% national sample can be requested by QEs for the purposes of developing benchmarks.

For more information on the years available and the expected timeline for the release of the QE Medicare data files, please refer to FAQ 39. Specific information about initiating the QE data request process may be found at http://www.resdac.org/cms-data/request/qualified-entity-program.



Cost Estimates for QE Medicare Data (Per Extract)


Pricing Bracket Parts A & B Claims and Enrollment Cost Per Extract Parts A & B Claims, Enrollment, and Part D Cost Per Extract
Up to 1 million beneficiaries $10,500 $14,500
1 million to 5 million beneficiaries $17,500 $24,000
5 million to 20 million beneficiaries $26,500 $35,500
Over 20 million beneficiaries $41,000 $54,000
5% National Sample for Benchmarking $3,975 $6,625


Beneficiary Count by State


State Beneficiary Count
Alabama (AL) 1,036,001
Alaska (AK) 93,247
Arizona (AZ) 1,234,774
Arkansas (AR) 634,390
California (CA) 6,100,283
Colorado (CO) 858,722
Connecticut (CT) 673,149
Delaware (DE) 195,914
District of Columbia (DC) 94,521
Florida (FL) 4,353,045
Georgia (GA) 1,652,027
Hawaii (HI) 264,197
Idaho (ID) 308,584
Illinois (IL) 2,214,709
Indiana (IN) 1,239,520
Iowa (IA) 615,456
Kansas (KS) 524,017
Kentucky (KY) 923,299
Louisiana (LA) 851,934
Maine (ME) 328,888
Maryland (MD) 1,007,974
Massachusetts (MA) 1,307,341
Michigan (MI) 2,035,915
Minnesota (MN) 986,836
Mississippi (MS) 597,931
Missouri (MO) 1,217,139
Montana (MT) 218,938
Nebraska (NE) 337,960
Nevada (NV) 496,672
New Hampshire (NH) 288,017
New Jersey (NJ) 1,598,239
New Mexico (NM) 404,050
New York (NY) 3,575,997
North Carolina (NC) 1,912,130
North Dakota (ND) 128,056
Ohio (OH) 2,314,428
Oklahoma (OK) 727,673
Oregon (OR) 821,343
Pennsylvania (PA) 2,709,944
Rhode Island (RI) 217,447
South Carolina (SC) 1,020,584
South Dakota (SD) 168,971
Tennessee (TN) 1,329,593
Texas (TX) 3,954,045
Utah (UT) 376,892
Vermont (VT) 142,085
Virginia (VA) 1,457,105
Washington (WA) 1,297,029
West Virginia (WV) 443,248
Wisconsin (WI) 1,135,328
Wyoming (WY) 103,598
All 50 States and D.C. (National) 58,529,185