Prescribers whose prescriptions cost Medicare the most

How to read this

• This is what the drugs cost, not what the prescriber earned. The figure is what Medicare, its plans and the patient paid pharmacies for what this prescriber wrote. None of it is income, and a doctor near the top of this list may have been paid nothing by anybody — what they are paid by drug companies is a different record, on the payment pages of this hub.
• The cost follows the drug, not the prescribing. One doctor writing a specialty drug that costs thousands a month outranks a hundred writing generics, so this ranks exposure to drug prices as much as anything a prescriber decided. The specialties show it: of the hundred, 11 are in Cardiology, 11 in Hematology-Oncology and 10 in Nurse Practitioner.
• This is 2024, and the payment pages on this hub are 2019 to 2025. Part D is published a year at a time by prescriber and this is the latest CMS has released. No figure here belongs in a sentence with an Open Payments figure as though the two covered the same period.
• A ranking of volume is not a finding about a doctor. Prescribing is what the specialty is: the top of every one of these lists is the specialty for which the measure is the daily work. The record holds what was filled, never why, and says nothing about whether any prescription was appropriate.
• A claim is a prescription filled, and counts every refill. A prescriber treating chronic conditions accumulates claims that a surgeon never will, so this is not a count of patients seen or of decisions made.
• The prescriber is an identifier, not always a person. CMS publishes an entity code distinguishing an individual from an organization, and the lists are overwhelmingly individuals — but the identifier is what is ranked, and prescriptions written under a supervising doctor’s number appear under theirs.