Medicaid drug utilization — Methodology
How Grand Rapids Care uses CMS Medicaid State Drug Utilization Data — aggregate public reporting, never patient-level data or clinical advice.
Medicaid figures come from the CMS Medicaid State Drug Utilization Data (SDUD), published by the Centers for Medicare & Medicaid Services (U.S. Government, public domain).
What source is used
The CMS Medicaid State Drug Utilization Data files, which report aggregate covered-outpatient-drug utilization and reimbursement by state and period.
What data is imported
Aggregate public figures only:
- Spending and units by state, year, and quarter, keyed to drug identifiers (NDC).
- A drug reference (names/manufacturers) to label NDCs.
This is aggregate public reporting — there is no patient-level data: no individuals, prescribers, diagnoses, or records.
How often it is refreshed
CMS publishes SDUD on a quarterly/annual cadence. We import on a recurring schedule; each view shows the latest period and import date.
How records are matched
Figures are organized by NDC and period. Where we surface manufacturers, we generate match candidates by normalized name; these are reviewed before any public linkage. Drug/manufacturer matching follows the same entity-matching principles.
What confidence means
Confidence applies to labeling/linkage (e.g., that an NDC maps to a named drug or manufacturer), not to any clinical judgment.
What the data can and cannot prove
- Can: show aggregate utilization and reimbursement trends as reported.
- Cannot: It is not patient-level data, and it is not clinical or prescribing advice. Aggregate totals reflect billing/utilization reporting — not the appropriateness of any individual prescription or provider.
Limitations
Aggregation, state reporting differences, rebates, and period boundaries all affect totals. Trends should be read as directional, in context.
Report a data issue
If a drug label or manufacturer linkage looks wrong, please contact us with the NDC and what you observed. We correct how data is labeled and displayed; we never alter the official source.
Sources
- CMS Medicaid State Drug Utilization Data — https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data/index.html
- Data files — https://data.medicaid.gov/
Related policies
In an emergency, call 911. This site provides general health information and is not medical advice.