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Data_Cost.html

Updated 1/6/2017

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 34. 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) 995,949
Alaska (AK) 84,909
Arizona (AZ) 1,146,194
Arkansas (AR) 614,084
California (CA) 5,764,235
Colorado (CO) 795,853
Connecticut (CT) 651,630
Delaware (DE) 183,116
District of Columbia (DC) 91,386
Florida (FL) 4,077,516
Georgia (GA) 1,548,043
Hawaii (HI) 249,664
Idaho (ID) 284,661
Illinois (IL) 2,135,560
Indiana (IN) 1,185,205
Iowa (IA) 590,419
Kansas (KS) 502,863
Kentucky (KY) 889,252
Louisiana (LA) 815,691
Maine (ME) 314,190
Maryland (MD) 955,084
Massachusetts (MA) 1,251,774
Michigan (MI) 1,951,396
Minnesota (MN) 933,416
Mississippi (MS) 578,146
Missouri (MO) 1,170,970
Montana (MT) 205,058
Nebraska (NE) 321,956
Nevada (NV) 456,643
New Hampshire (NH) 272,410
New Jersey (NJ) 1,541,719
New Mexico (NM) 379,951
New York (NY) 3,449,891
North Carolina (NC) 1,805,451
North Dakota (ND) 122,815
Ohio (OH) 2,222,294
Oklahoma (OK) 701,004
Oregon (OR) 764,937
Pennsylvania (PA) 2,619,521
Rhode Island (RI) 209,844
South Carolina (SC) 954,482
South Dakota (SD) 159,759
Tennessee (TN) 1,268,930
Texas (TX) 3,708,029
Utah (UT) 350,321
Vermont (VT) 134,577
Virginia (VA) 1,379,724
Washington (WA) 1,206,695
West Virginia (WV) 432,134
Wisconsin (WI) 1,076,715
Wyoming (WY) 97,103
All 50 States and D.C. (National) 55,603,169