Which state prescribes the most opioids in Medicare Part D?

In 2024, California led the nation with 4,885,026 opioid claims under Medicare Part D (3.2% of its Part D prescriptions). The full state-by-state ranking — opioid claims and opioid share of all prescriptions — is below.

What share of Medicare Part D prescriptions are opioids?

Nationally in 2024, opioids accounted for 3.5% of all Medicare Part D claims — 59,133,014 opioid claims out of 1,709,828,271 total. Opioid share varies widely by state; see the ranking below.

Where does this opioid prescribing data come from?

Figures come from the CMS Medicare Part D Prescribers dataset, a per-provider summary CMS publishes annually. It reports each prescriber's opioid claim counts alongside their total Part D claims, so opioid volume and opioid share can be aggregated by state and specialty. It reflects Medicare Part D only — not Medicaid, commercial insurance, or cash prescriptions.

DATA STUDY · 2025 EDITION · CMS MEDICARE PART D · 2024

Opioid Prescribing by State in Medicare Part D

In 2024, Medicare Part D providers wrote 59,133,014 opioid claims — 3.5% of all 1,709,828,271 Part D prescriptions. California led the nation. Below: every state ranked by opioid volume and by opioid share of all prescribing. Each state links to its full CareTrace profile. Drawn from the latest CMS Medicare Part D release; updated annually.

59,133,014

TOTAL OPIOID CLAIMS

3.5%

OPIOID SHARE OF PART D

1,709,828,271

TOTAL PART D CLAIMS

1,416,883

PRESCRIBERS ANALYZED

▸ STATES PRESCRIBING THE MOST OPIOIDS

Total Medicare Part D opioid claims by state — top 12

▸ EVERY STATE RANKED

Medicare Part D opioid prescribing, state by state

Ranked by total opioid claims in 2024. Opioid share is opioid claims as a percentage of all Part D claims in the state. Each state links to its full CareTrace profile.

#	State	Opioid claims	Opioid share	All Part D claims	Prescribers
1	California	4,885,026	3.2%	151,834,237	143,204
2	Florida	4,517,713	3.5%	130,255,413	97,257
3	Texas	4,075,880	3.6%	114,622,272	95,720
4	North Carolina	2,473,245	4.1%	60,423,416	45,303
5	Michigan	2,388,176	4.1%	57,827,200	47,240
6	Pennsylvania	2,388,145	2.9%	83,420,338	65,806
7	Georgia	2,300,354	4.3%	54,009,472	37,951
8	Ohio	2,259,402	3.2%	71,184,579	54,590
9	New York	2,163,771	2.0%	110,658,668	106,124
10	Tennessee	1,920,669	4.3%	44,346,934	29,866
11	Illinois	1,841,121	3.1%	59,907,161	53,816
12	Indiana	1,676,958	4.2%	39,967,708	26,776
13	Alabama	1,674,479	5.2%	32,456,175	18,322
14	Missouri	1,548,017	3.9%	39,797,656	26,154
15	Kentucky	1,467,466	4.4%	33,224,940	19,568
16	Louisiana	1,243,728	4.1%	30,157,903	20,790
17	Washington	1,243,415	4.2%	29,956,750	33,339
18	Arizona	1,203,453	4.0%	30,410,551	30,663
19	Virginia	1,202,894	3.2%	37,429,745	33,533
20	South Carolina	1,199,885	4.0%	30,252,422	22,190
21	Wisconsin	1,005,695	3.2%	31,645,750	26,027
22	Massachusetts	1,003,409	2.6%	38,221,988	40,651
23	New Jersey	985,514	2.3%	41,988,385	37,320
24	Oklahoma	983,613	4.7%	20,886,527	14,439
25	Arkansas	958,894	4.7%	20,469,424	12,160
26	Colorado	921,886	4.5%	20,345,463	24,613
27	Oregon	886,125	4.6%	19,299,409	19,553
28	Maryland	859,970	3.6%	23,670,488	27,112
29	Minnesota	804,061	2.9%	27,270,073	26,278
30	Mississippi	762,931	4.0%	19,034,186	10,881
31	Kansas	670,624	4.1%	16,432,644	11,827
32	Iowa	580,078	3.1%	18,689,967	13,437
33	Nevada	539,933	4.6%	11,796,023	10,732
34	Connecticut	536,824	2.7%	19,967,850	20,119
35	Utah	518,162	5.0%	10,378,032	11,663
36	Idaho	412,733	4.9%	8,368,906	7,714
37	West Virginia	406,570	3.1%	12,941,780	8,677
38	Nebraska	358,809	3.3%	10,927,337	8,489
39	New Mexico	310,956	3.8%	8,264,710	8,416
40	Maine	257,539	3.2%	8,010,923	7,378
41	Montana	226,131	4.3%	5,271,302	5,025
42	New Hampshire	201,919	2.9%	7,011,147	7,251
43	Delaware	187,366	3.6%	5,223,073	4,475
44	Puerto Rico	175,941	0.6%	30,927,797	11,228
45	South Dakota	167,179	3.4%	4,942,049	4,109
46	Rhode Island	153,420	2.3%	6,537,839	5,928
47	North Dakota	127,352	2.9%	4,385,406	3,599
48	Hawaii	122,222	2.7%	4,606,315	5,044
49	Vermont	96,834	3.1%	3,098,094	3,021
50	Wyoming	96,046	4.5%	2,146,957	2,212
51	Alaska	70,673	3.7%	1,924,823	3,139
52	District of Columbia	60,053	2.4%	2,492,986	5,295
53	AE	1,951	4.9%	40,200	125
54	ZZ	1,936	3.4%	56,855	155
55	AP	1,815	4.8%	38,050	112
56	Guam	1,643	1.6%	105,248	178
57	U.S. Virgin Islands	1,509	0.8%	200,692	180
58	XX	634	1.4%	45,616	33
59	AA	182	4.4%	4,126	36
60	Northern Mariana Islands	85	0.5%	16,055	37
61	American Samoa	0	0.0%	84	2
62	FM	0	0.0%	152	1

▸ BY SPECIALTY

Which specialties prescribe the most opioids

Total Medicare Part D opioid claims by prescriber specialty in 2024. Click any specialty to see its top Medicare providers.

Family Practice11,500,448 Nurse Practitioner11,162,119 Internal Medicine8,271,908 Physician Assistant6,750,312 Pain Management2,843,307 Physical Medicine and Rehabilitation2,451,689 Anesthesiology2,437,543 Orthopedic Surgery2,298,728 Interventional Pain Management2,167,073 Emergency Medicine1,248,831 Dentist761,304 General Surgery690,637 Rheumatology653,300 Hematology-Oncology573,719 General Practice494,231 Oral Surgery (Dentist only)479,422 Neurology431,697 Urology372,153 Hospitalist302,302 Podiatry275,015

Methodology

Figures come from the CMS Medicare Part D Prescribers dataset for 2024 — a per-provider summary CMS publishes annually. Each prescriber row reports opioid claim counts alongside total Part D claims. We sum opioid claims and total claims by the provider's state (and specialty), then compute opioid share as opioid claims divided by all Part D claims. The data reflects Medicare Part D only — not Medicaid, commercial insurance, or cash prescriptions — so state totals track each state's Medicare population as well as its prescribing patterns.

Opioid prescribing has legitimate clinical uses, including cancer and end-of-life care; a higher opioid share is not by itself evidence of misuse. This study is a transparency lens, not an allegation. Want the opioid and overall prescribing profile for a specific provider? Use provider search or browse a state profile.

▸ USE THIS RESEARCH

Cite or embed this study

This research is free to reference. Journalists and researchers are welcome to cite the figures with a link back to CareTrace.

CITATION

CareTrace. (2024). Opioid Prescribing by State in Medicare Part D. Retrieved from https://caretrace.io/opioid-prescribing-by-state

EMBED THIS STAT (paste the HTML into your article)

<a href="https://caretrace.io/opioid-prescribing-by-state" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>Opioids were 3.5% of all Medicare Part D claims — 59,133,014 opioid prescriptions</strong><br>Source: CareTrace — Opioid Prescribing by State in Medicare Part D (2024)</a>

PREVIEW

Opioids were 3.5% of all Medicare Part D claims — 59,133,014 opioid prescriptions
Source: CareTrace — Opioid Prescribing by State in Medicare Part D (2024)