MAX Prescription Drug File

The Prescription Drug File contains final action, paid drug claims.  Since 1996, the dispensed drug has been identified by an NDC. Drugs or supplies identified by HCPCS (CMS Health Care Common Proceedure Codes) or any state-specific codes, are included in the MAX Other Therapy (OT) file.  The Prescription Drug file does not contain any diagnosis nor procedure codes.  With the implementation of the Medicare Part D Prescription Drug Program in 2006, drugs dispensed for the Medicare-Medicaid dually eligible which are part of the Part D formulary,  will be found in the Medicare Part D Event file.  This means that nearly all drugs for dually eligible population will be found only in the Medicare PDE file.

Availability: 
CY 1999 - 2014

MAX 2014 Currently 17 states can be requested: CA, GA, ID, IA, LA, MI, MN, MS, MO, NJ, PA, SD, TN, UT, VT, WV, WY

GA, IA, MS, MO, NJ, PA, SD, TN, VT, WV, WY

MAX 2013 Currently 28 states can be requested. These include: AR, AZ, CA, CT, GA, HI, IA, ID, IN, LA, MA, MI, MN, MO, MS, NJ, NY, OH, OK, OR, PA, SD, TN, UT, VT, WA, WV, WY.

MAX 2012 Currently 47 states can be requested. At this time, four states have not submitted the necessary MSIS or T-MSIS files. MAX 2012 is currently not available for CO, ID, KS, RI.

MAX 2011 Files are available for all states except CO. ME is limited to only the PS and RX files.

MAX production for the missing state/year combinations noted above may be undertaken after data are received and approved by CMS in the new T-MSIS format.

CMS cannot estimate or confirm anticipated release dates for additional MAX data.

Researchers are reminded that data costs are affected by cohort size, files requested and years of data. Charges are per data request or amendment. eg: if 30 states are needed for MAX 2013 and the researcher chooses to make a request for the 20 states that are currently available and amend later when the other 10 become available, they will pay again for the remaining 10 states. Depending on cohort size, it might be more cost effective to wait to request the 30 states at one time when all are available rather than pay for two cohort pulls.

Data File Classification