Claims - The All Payer Claims Database (APCD)

Maine has collected health insurance claims information in its APCD since 2003. The APCD currently holds claims from commercial insurance carriers, third party administrators (TPAs), pharmacy benefit managers (PBMs), dental benefit administrators, MaineCare(Maine Medicaid), and CMS (Medicare).

Health care claims processors must submit periodically (typically monthly) to the MHDO, a completed health care claims data set for all members who are Maine residents. The submissions include files with member eligibility, medical claims, pharmacy claims, and/or dental claims information.

See Rule Chapter 243 on our rules page for a complete definition of what entities must submit data and what data must be submitted.

MHDO makes available new and updated data quarterly. Historical data is available upon request.

11/09/15 - Data Dictionaries Updated

See our newest Data Dictionaries and accompanying explanation documents, which were released November 6th with the Q2 2015 APCD data.

Recent Releases

Q1 2016 APCD Data (MaineCare and Medicare Q1 & Q2 2015) were released July 8, 2016. Below are documents provided to users as part of the release.

Q4 2015 APCD Data (Commercial and MaineCare) were released April 22, 2016. Below are documents provided to users as part of the release.

Q3 2015 APCD Data (Commercial and MaineCare) were released January 22, 2016. Below are documents provided to users as part of the release.

Q2 2015 APCD Data (Commercial, MaineCare and Medicare Q4 2014) were released November 6, 2015. Below are documents provided to users as part of the release.

Q1 2015 APCD Data (Commercial, MaineCare and Medicare Q1-Q3 2014) were released July 24, 2015. Below are documents provided to users as part of the release.

Q4 2014 APCD Data (Commercial and MaineCare) were released 5/1/15. Below are documents provided to users as part of the release.

Q3 2014 APCD Data (Commercial, MaineCare and Medicare Q4 2013) were released 1/16/15. Below are documents provided to users as part of the release.

Q2 2014 APCD Data (Commercial, MaineCare and Medicare Q3 2013) were released 10/24/14. Below are several documents provided to users as part of the release.

Q1 2014 APCD Data (Commercial and MaineCare) were released 8/5/14. As we continue to work on improving our documentation we provided users with several documents as part of the release.

APCD Data were released 7/1/14. This release included Q3 2013 (including the backfill data for previous quarters), Q4 2013, and historical refresh files. The release notes are available for this release as well.


Prices can be found on our Pricing page, and if you want to request data, the information can be found on our Request Data or Reports page.