Abstract: Medication utilization and associated cost evaluation with secondary data is not as well understood with medical benefit drug claims (MBDC) as it is for pharmacy claims. Coding for MBDC uses HCPCS codes for reimbursement; National Drug Codes are used for pharmacy reimbursement. MBDCs also include medication administration, diagnostics and testing services not typically part of traditional pharmacy claims. A comprehensive MBDCs terminology was developed with an HCPCS-NDC cross-walk and validated using a state population database.

Learning Objective 1: Appreciate the medication administrative coding systems used for medication use

Learning Objective 2: Understand the limitations of medication administrative codes currently in use

Learning Objective 3: Gain an understanding of currently knowledge gaps in secondary data for medications


Terrence Adam (Presenter)
University of Minnesota

Bithia Anderson, University of Minnesota
Angeline Carlson, Data IQ
Mahsa Salsabili, University of Minnesota
Glenn Trygstad, Data IQ
Stephen Schondelmeyer, University of Minnesota

Presentation Materials: