Antipsychotics 2015

data.medicaid.gov | Last Updated 25 Sep 2019

Drug utilization data are reported by states for covered outpatient drugs that are paid for by state Medicaid agencies since the start of the Medicaid Drug Rebate Program. The data includes state, drug name, National Drug Code, number of prescriptions and dollars reimbursed. Data descriptions are available on Medicaid.gov: https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/state-drug-utilization-data-faq/index.html

Tags: drug utilization, medicaid reimbursements, pharmacy

This dataset has the following 20 columns:

Column NameAPI Column NameData TypeDescriptionSample Values
Utilization Typerecord_idtextConstant “FFSU” or “MCOU”. The FFSU Record ID indicates that the information for this National Drug Code (NDC) represents a fee-for-service (FFS) utilization record. The MCOU Record ID indicates that the information for this NDC represents a managed care organization (MCO) utilization record. Valid Values: 4Q2009 and earlier = Constant record ID of FFSU.1Q2010 and beyond = FFSU & MCOU. NOTE: Per the Affordable Care Act, MCO utilization data cannot be reported for periods prior to 1Q2010. Utilization Type was previously known as "Record ID."
Statestate_codetextTwo-character post office abbreviation for State. NOTE: For any data where NDCs are aggregated (e.g. National Totals) the state code is “XX” to represent multiple states. State was previously known as "State Code".
Labeler Codelabeler_codetextFirst segment of NDC that identifies the manufacturer, labeler, relabeler, packager, repackager or distributor of the drug.
Product Codeproduct_codetextSecond segment of NDC.
Package Sizepackage_sizetextThird segment of NDC.
Yearperiod_coveredtextCalendar year. Year was previously known as "Period Covered"
QuarterquartertextQuarter of year (1-4) 1 = January 1 - March 31, 2 = April 1 - June 30, 3 = July 1 - September 30, 4 = October 1 - December 31. Quarter was previously known as "Period Covered"
Product Nameproduct_fda_list_nametextFirst 10 characters of product name as approved by the FDA listing form. Product Name was previously known as "Product FDA List Name"
Suppression Usedsuppression_usedcheckboxThe state drug utilization data includes state, drug name, NDC, number of prescriptions, and dollars reimbursed. As CMS is obligated by the federal Privacy Act, 5 U.S.C. Section 552a and the HIPAA Privacy Rule, 45 C.F.R Parts 160 and 164, to protect the privacy of individual beneficiaries and other persons, all direct identifiers have been removed and data that are less than eleven (11) counts are suppressed. A checkmark in the "Suppression Used" column notes suppressed data. CMS applies counter or secondary suppression in cases where only one prescription is suppressed for primary reasons (e.g., one prescription in a state). Also, if one sub-group (e.g., number of prescriptions) is suppressed, then the other sub-groups are suppressed.
Units Reimbursedunits_reimbursednumberFFS Units- The number of units (based on Unit Type) of the drug 11-digit NDC reimbursed by the state during the quarter/year covered. MCO Units-The number of units (based on Unit Type) of the 11-digit NDC dispensed during the quarter/year covered.
Number of Prescriptionsnumber_of_prescriptionsnumberThe number of prescriptions should include any prescription for which Medicaid paid a portion of the claim, as well as those prescriptions for which Medicaid paid the claim in full. FFS-The number of prescriptions reimbursed by the state Medicaid agency as outpatient drug claims during the quarter/year covered. MCO-The number of prescriptions dispensed as outpatient drug claims during the quarter/year covered.
Total Amount Reimbursedtotal_amount_reimbursednumberThe FFS or MCO total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the 11-digit NDC drug in the period covered (two previous fields added together). This total is not reduced or affected by Medicaid rebates paid to the state. This amount represents both federal and state reimbursement and is inclusive of dispensing fees. NOTE: As capitated payment arrangements are sometimes utilized by states and MCOs, a zero value in this field could be appropriate for MCO data; however, FFS utilization records will reject if this field is reported with a value of zero.
Medicaid Amount Reimbursedmedicaid_amount_reimbursednumberThe amount reimbursed by the Medicaid Program ONLY topharmacies for the 11-digit NDC FFS or MCO drug in the quarter/year covered. This total is not reduced or affected by Medicaid rebates paid to the state. This amount represents both federal and state reimbursement and is inclusive of dispensing fees. NOTE: As capitated payment arrangements are sometimes utilized by states and MCOs, a zero value in this field could be appropriate for MCO data; however, FFS utilization records will reject if this field is reported with a value of zero.
Non Medicaid Amount Reimbursednon_medicaid_amount_reimbursednumberThe amount reimbursed by non-Medicaid entities to pharmacies for the 11-digit NDC FFS or MCO drug in the quarter/year covered. The Non-Medicaid Amount Reimbursed includes any reimbursement amount for which the state is not eligible for federal matching funds
Quarter Begin_quarter_begintextBeginning date for quarter. Derived field provides ability to create comparisons over time. Can be used as a label for timelines.
Quarter Begin Date_quarter_begin_datecalendar_dateBeginning date for quarter. Derived field provides ability to create comparisons over time. Also can be used to create timeline visualizations
Latitude_latitudenumberLocation within state. Derived from state code provides ability to create maps and geographic comparisons.
Longitude_longitudenumberLocation within state. Derived from state code provides ability to create maps and geographic comparisons.
Location_locationlocationLocation within state. Derived from state code provides ability to create maps and geographic comparisons.
NDCndctextThe National Drug Code (NDC) is a numerical code maintained by the FDA that includes the labeler code, product code, and package code. The NDC is an 11-digit code.