CMS Drug Utilization
Provided By: John Snow Labs
CMS Drug Utilization
Provided By: John Snow Labs
This data package contains the information on labelers and products in the Medicaid Drug Utilization Review Program as collected through the Newly Revised Medicaid Drug Utilization Review Annual Report Survey released in 2014, regarding prescriptions and reimbursements.
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Public offer
Payment schedule: Upfront payment | Offer auto-renewal: Supported
$0 for 12 months
Overview
Overview
This data package contains the Medicaid Drug Utilization Review (DUR) Program promotes patient safety through state-administered utilization management tools and systems that interface with CMS’ Medicaid Management Information Systems (MMIS). Medicaid DUR is a two-phase process that is conducted by the Medicaid state agencies. In the first phase (prospective DUR) the state’s Medicaid agency’s electronic monitoring system screens prescription drug claims to identify problems such as therapeutic duplication, drug-disease contraindications, incorrect dosage or duration of treatment, drug allergy and clinical misuse or abuse. The second phase (retrospective DUR) involves ongoing and periodic examination of claims data to identify patterns of fraud, abuse, gross overuse, or medically unnecessary care and implements corrective action when needed. On an annual basis, states are required to report on their state’s prescribing habits, cost savings generated from their DUR programs and their program’s operations, including the adoption of new innovative DUR practices via the Medicaid Drug Utilization Review Annual Report Survey.
License Information
The use of John Snow Labs datasets is free for personal and research purposes. For commercial use please subscribe to the Data Library on AWS. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.
Metadata
| Description | Value |
|---|---|
| Data Package Complexity | Simple |
| Available Enrichments | N/A |
| Keywords | CMS Drug Utilization, DUR, Prescription Drug Monitoring, Managed Care Organizations, Medicare Utilization Review, CMS Annual Report Survey, Utilization Management, CMS Drug Reports, CMS Drug Utilization, DUR Annual Drug Report |
| Other Titles | Drug Utilization Annual Report, Drug Utilization Survey, National Summary State Drug |
Included Datasets
CMS Drug Utilization Review
This dataset contains information on labelers and products in the Medicaid Drug Utilization Review Program as collected through the Newly Revised Medicaid Drug Utilization Review Annual Report Survey, regarding prescriptions and reimbursements. The DUR Annual Report Survey included since 2014 new sections on fraud, waste and abuse, Prescription Drug Monitoring Program and state Managed Care Organizations.
CMS Opioid Utilization Review
This dataset contains information about the opioid products in the Medicaid Drug Utilization Review Program as collected through the Newly Revised Drug Utilization Review (DUR) Annual Report Survey. This survey included since 2014 new sections on fraud, waste and abuse, Prescription Drug Monitoring Program and state Managed Care Organizations. This specific dataset is an extraction of the opioids in the main DUR dataset.
Data Engineering Overview
We deliver high-quality data
- Each dataset goes through 3 levels of quality review
- 2 Manual reviews are done by domain experts
- Then, an automated set of 60+ validations enforces every datum matches metadata & defined constraints
- Data is normalized into one unified type system
- All dates, unites, codes, currencies look the same
- All null values are normalized to the same value
- All dataset and field names are SQL and Hive compliant
- Data and Metadata
- Data is available in both CSV and Apache Parquet format, optimized for high read performance on distributed Hadoop, Spark & MPP clusters
- Metadata is provided in the open Frictionless Data standard, and its every field is normalized & validated
- Data Updates
- Data updates support replace-on-update: outdated foreign keys are deprecated, not deleted
Our data is curated and enriched by domain experts
Each dataset is manually curated by our team of doctors, pharmacists, public health & medical billing experts:
- Field names, descriptions, and normalized values are chosen by people who actually understand their meaning
- Healthcare & life science experts add categories, search keywords, descriptions and more to each dataset
- Both manual and automated data enrichment supported for clinical codes, providers, drugs, and geo-locations
- The data is always kept up to date – even when the source requires manual effort to get updates
- Support for data subscribers is provided directly by the domain experts who curated the data sets
- Every data source’s license is manually verified to allow for royalty-free commercial use and redistribution.
Need Help?
- If you have questions about our products, contact us at info@johnsnowlabs.com.
About Us
John Snow Labs , an AI and NLP for healthcare company, provides state-of-the-art software, models, and data to help healthcare and life science organizations build, deploy, and operate AI projects.
Provided By
Fulfillment Method
AWS Data Exchange
Data dictionaries
A data dictionary is a visual representation of the contents of a data set. The data represented here is for evaluation purposes only and may not accurately represent the actual content of the product.
Field name | Description | Example | Data type | Primary key | Nullable | Max length | Data set | Table name | Table description |
|---|---|---|---|---|---|---|---|---|---|
Utilization_Type | The FFSU Record ID indicates that the information for this NDC represents a Fee-for-Service Utilization record. The MCOU Record ID indicates that the information for this NDC represents a Managed Care Organization Utilization record. | - | string | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
State_Code | Two-character post office abbreviation for the state. | - | string | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
NDC | Full National Drug Code (NDC) that includes the labeler code, the product code and the package size of the drug. | 2431208 | integer | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Labeler_Code | First segment of National Drug Code (NDC1) that identifies the manufacturer, labeler, relabeler, packager, repackager or distributor of the drug. | - | integer | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Product_Code | Second segment of National Drug Code (NDC2) | - | integer | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Package_Size | Third segment of National Drug Code (NDC3) | - | integer | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Is_Suppression_Used | Refers to whether suppression used or not | - | boolean | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Product_FDA_Name | (Abbreviated) – First 10 characters of product name as approved by the FDA listing form | - | string | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
Units_Reimbursed_USD | The total number of units (based on Unit Type) of the drug (11-digit NDC level) reimbursed by the state during the period covered. | - | numeric | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review | |
No_Prescriptions | The number of prescriptions reimbursed (by the Medicaid Program ONLY) to pharmacists for the (11-digit NDC) drug for the period covered. | - | integer | - | - | - | CMS Drug Utilization Review | cms_drug_utilization_review |
Data sets (2)
You will receive access to the following data sets
Revision access rules
All historical revisions | All future revisions
Name | Type | Data dictionary | AWS Region |
|---|---|---|---|
CMS Opioid Utilization Review | Included | US East (N. Virginia) | |
CMS Drug Utilization Review | Included | US East (N. Virginia) |
Data dictionaries and samples
Sample data is for evaluation purposes only and may not accurately represent the actual content of the product.
Name | Resource | File type | File size | Description | ||
|---|---|---|---|---|---|---|
CMS Drug Utilization Review | Data set | - | - | - | ||
Data dictionary | Data dictionary | text/csv | - | |||
CMS Opioid Utilization Review | Data set | - | - | - |
Usage information
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Support information
Support contact email address
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No refunds offered. For any questions email us at info@johnsnowlabs.com
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