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Frequently Asked Questions

Frequently Asked Questions are used to provide additional information and/or statutory guidance not found in State Medicaid Director Letters, State Health Official Letters, or CMCS Informational Bulletins. The different sets of FAQs as originally released can be accessed below.

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Are drugs used in hospital outpatient settings excluded from the Medicaid Drug Rebate Program?

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

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I noticed a discrepancy in the State Drug Utilization Data (SDUD), what do I do?

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

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How often are the State Drug Utilization Data (SDUD) and the National Summary Utilization Data updated and posted to the website?

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

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What Dataset Views are available for the State Drug Utilization Data (SDUD)?

Per the state drug utilization data table, the "Dataset Views" dropdown selections available are:

  • State: State-specific data at the NDC-11 level, for a quarter/year.
  • Full Dataset (States + National Totals): A compilation of all the individual state utilization data (50 states plus Washington D.C.) and the National Totals at the NDC-11 level, for a selected year.
  • All States: Includes data for all states but does not include the National Totals
  • National Totals: Data are aggregated for all 50 states and Washington, D.C. at the NDC-11 level, for a quarter/year.

Since all of the states are combined in the National Totals, the state abbreviation will show on the "Annual State Detail" with a state abbreviation of "XX".

Users can also generate his or her own views of the dataset on data.medicaid.gov.

FAQ ID:91786

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Why am I unable to see all of the data in the dataset/view?

You are likely running into a limitation of the program you are trying to use to analyze the data. Microsoft Excel allows 1,048,576 rows of data and many of our datasets exceed this limit.

We recommend users not use Excel for large datasets but instead use another application that can work with datasets of large size (e.g. Microsoft Access).

FAQ ID:91801

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Why is there a State column labeled XX when viewed as National Totals in the State Drug Utilization Data (SDUD)?

Since all of the states are combined in the National Totals, the state abbreviation will show on the "National Totals" and "Annual State Detail" option as "XX".

See Also:

FAQ ID:91811

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Why does some State Drug Utilization Data (SDUD) have an asterisk?

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. An asterisk (*) 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 prescription) is suppressed, then the other sub-group is suppressed.

See Also:

FAQ ID:91831

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Is the redacted State Drug Utilization Data (SDUD) available to the public?

No. In accordance with federal laws, State Drug Utilization Data (SDUD) that has been suppressed is not available for public consumption.  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-group is suppressed.

FAQ ID:91856

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Does the State Drug Utilization Data (SDUD) reported for each quarter's posting always include all of the quarterly data reported by states?

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

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