State Medicaid Outpatient Drug Utilization and Reimbursements 2025

State-reported data details Medicaid-covered outpatient drug utilization and payments. It includes state, drug name, National Drug Code, prescription counts, and reimbursement dollars. The data is reported by state Medicaid agencies and was last updated in December 2025.

Use Cases

• Analyze prescription counts by drug name to identify high-utilization medications across states.
• Model reimbursement dollars against National Drug Code to assess state-level Medicaid drug expenditure patterns.
• Compare drug utilization metrics between states to benchmark Medicaid program performance.
• Track prescription and spending trends for specific National Drug Codes over time.

Strengths

• Data is sourced from the authoritative U.S. Department of Health & Human Services.
• Covers drug utilization for the Medicaid program across all reporting states.
• Includes key financial and utilization metrics like prescription counts and reimbursement dollars.

Limitations

• The specific number of rows, columns, and data size are unknown, limiting assessment of scale.
• Data completeness relies on state reporting compliance, which may vary.
• The dataset may not include all outpatient drugs if not covered or reimbursed by Medicaid.

Provenance

Source

U.S. Department of Health & Human Services

Collection Method

Reported by state Medicaid agencies for covered outpatient drugs under the Medicaid Drug Rebate Program.

Time Range

Since the start of the Medicaid Drug Rebate Program; specific coverage period for the 2025 file is unknown.

Freshness

Last updated on 2025-12-12.

Geography

United States (state-level data)