Frequently Asked Questions

If a covered outpatient drug is billed as an outpatient drug and not part of a bundled service, it is rebate-eligible.

FAQ ID:92091

Should you notice apparent discrepancies in an individual state's utilization data, your questions should be directed to the State Technical Contact.

FAQ ID:92096

The Centers for Medicare & Medicaid (CMS) posts updated State Drug Utilization Data (SDUD) according to the following schedule:

• 1st Quarter (plus 5 preceding years of data): Available in August, and includes any late data reporting for 1st Quarter received from States through the end of June, plus any updates to the five preceding years of data.
• 2nd Quarter (plus 5 preceding years of data): Available in November, and includes any late data reporting for 2nd Quarter received from States through the end of September, plus any updates to the 5  preceding years of data.
• *3rd Quarter (update of all preceding years): Available in February, and includes any late data reporting for 3rd Quarter received from States through the end of December, plus any updates to the five preceding years of data.
• 4th Quarter (plus 5 preceding years of data): Available in May, and includes any late data reporting for 4th Quarter received from States through the end of March, plus any updates to the five preceding years of data.

*An update of all preceding years of State Drug Utilization Data (1991 to 3rd Quarter) are posted to the website annually during the month of February. The data posted includes utilization information received from States through the end of December. The National Totals represent aggregate data by NDC-11.

See Also: With regards to State Drug Utilization Data (SDUD), is the data for each quarter's posting always comprehensive?

FAQ ID:92101

If the data arrives late, it may miss the quarterly posting. However, it will be included in the next quarter's web posting.

FAQ ID:91916

For current versions of MDRP File Formats/Data Definitions, please refer to: https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-drug-rebate-program-mdrp-file-formats-data-definitions-and-medicaid-drug-programs-mdp-email-communications/index.html

See Also:

• What fields changed when CMS moved the State Drug Utilization Data (SDUD) to data.medicaid.gov?
• Is the redacted State Drug Utilization Data (SDUD) available to the public?

FAQ ID:91956

A Non-Medicaid Reimbursed amount is any amount paid on a claim by parties other than Medicaid (e.g., other federal coverage, co-pay, private insurance). If a state receives Federal Financial Participation (FFP) for any part of a claim for a Covered Outpatient Drug (COD), that portion of the claim is included in the Medicaid Reimbursed amount. If a state does not receive FFP for any part of a rebate-eligible claim, then the amount of the claim is included in the Non-Medicaid Reimbursed amount.

FAQ ID:91981

The sum of the “Medicaid Amount Reimbursed” and the “Non-Medicaid Amount Reimbursed” fields should generally equal the Total Amount Reimbursed on a National Drug Code (NDC) by NDC basis; however, these new fields were implemented beginning with the fourth quarter of 2007 and are optional for the states to report prior to that time. Therefore, for quarters earlier than fourth quarter 2007, there may be some large discrepancies between the Total Amount Reimbursed and the sum of the Medicaid Amount Reimbursed and the Non-Medicaid Amount Reimbursed because the Non-Medicaid Amount Reimbursed is often not present for those earlier quarters. Should you notice apparent discrepancies in an individual state's utilization data, your questions should be directed to the State Technical Contact.

FAQ ID:91986