CMS Drug Utilization

**Overview**
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.

**Description**
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.

**Benefits**
- 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).

**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](https://www.johnsnowlabs.com/marketplace/) on John Snow Labs website. The subscription will allow you to use all John Snow Labs datasets and data packages for commercial purposes.

**Included Datasets**
- [CMS Drug Utilization Review](https://www.johnsnowlabs.com/marketplace/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](https://www.johnsnowlabs.com/marketplace/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.

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搜集汇总

背景与挑战

背景概述

该数据集包含2014年新版医疗补助药物利用审查年度报告调查中收集的标签商和产品信息，涉及处方和报销情况。医疗补助DUR计划通过州级管理工具和系统促进患者安全，包括前瞻性和回顾性两个阶段的药物利用审查。