[SO/URSA-PHARM] Targeted Medication Fills with Medication Therapy Episodes

Object Description

One record per outpatient fill for any of the following targeted medication types: antidepressants, antineoplastics, beta blockers, antidiabetics, ACEI/ARBs, statins, high-risk medications (anticoagulants, oral antiplatelets, cardiac glycosides, opiate agonists, oral hypoglycemics, insulin), and other chronic medications

Metadata

• Table Name: ursa.so_ursa_pharm_meds_002
• Layer: SYNTHETIC_OBJECT
• Object Type: Medication Therapy Episode
• Temporal Class: Event
• Case ID: Document ID
• Event Date: Filled Date
• Primary Key: Document ID

Published Fields

• Data Model Keys

  • Document ID -- The internal database identifier (used, e.g., for joins and primary keys) for the document. (See also [URSA-CORE] Document)
  • Claim ID -- The internal database identifier (used, e.g., for joins and primary keys) for the claim. (See also [URSA-CORE] Claim)
  • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
  • Filling Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the filling provider.
  • Prescribing Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the prescribing provider. (See also [URSA-CORE] Prescribing Provider)
  • Lifetime Medication Treatment Episode ID

• Operations Support Fields

  • Prescription Number -- The unique, user-facing (“real-world”) identifier used by operational systems or staff to identify the medication order. (See also [URSA-CORE] Medication Order)

• Date Fields

  • Filled Date -- The date a prescription or medication order was filled, with medications dispensed.

• Provider Fields

  • Prescribing Provider NPI -- The 10-digit National Provider Identifier for the prescribing provider. (See also [URSA-CORE] Prescribing Provider)
  • Filling Provider NPI -- The 10-digit National Provider Identifier for the filling provider. (See also [URSA-CORE] Filling Provider)
  • Filling Provider Description -- The natural language description of the filling provider. (See also [URSA-CORE] Filling Provider)
  • Provider Fill Volume Percentile Rank
  • Provider Fill Volume Quintile Category
  • Is Filling Provider Major Chain
  • Filling Provider Major Chain Description
  • Filling Provider State Abbreviation
  • Filling Provider ZIP Code 5-Digit
  • Filling Provider Primary NUCC Provider Taxonomy Code -- The primary NUCC Provider Taxonomy code for the filling provider. (See also [URSA-CORE] Filling Provider, [URSA-CORE] Primary NUCC Provider Taxonomy Code)
  • Filling Provider Primary NUCC Provider Taxonomy Description -- The primary NUCC Provider Taxonomy description for the filling provider. (See also [URSA-CORE] Filling Provider, [URSA-CORE] Primary NUCC Provider Taxonomy Description)
  • Is Filling Provider Specialty Pharmacy -- A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.
  • Is Filling Provider Mail Order Pharmacy -- Indicates the filling provider is a mail-order pharmacy. (See also [URSA-CORE] Filling Provider)

• Medication Fields

  • NDC Code 11-Digit -- The standard 11-digit National Drug Code; e.g., 00045012400 = Tylenol 500 mg.
  • Label Description -- Supplies the name given to the product by the manufacturer.
  • Active Ingredients Description -- A natural language description of the medication's biologically active ingredient(s). For medications with multiple active ingredients, the active ingredients should be listed in alphabetical order.
  • Primary Agent Description -- The primary active ingredient in the medication. In medications with multiple active ingredients, this identifies by name only the primary agent.
  • Form Description -- The natural language description of the medication's form. (See also [URSA-CORE] Medication Form)
  • Route of Administration Description -- The natural language description of the medication's route of administration.
  • Is OTC -- Indicates that the medication is an over-the-counter (OTC) drug that does not require a prescription.
  • AHFS Therapeutic Class Code 6-Digit -- The standard 6-digit AHFS Pharmacologic-Therapeutic Class Code, representing the first 3 tiers of the AHFS Pharmacologic-Therapeutic Classification system. The code is expressed as 6 numbers, without special characters delimiting the tiers, with leading and trailing zeros as needed. (See also [URSA-CORE] AHFS Pharmacologic-Therapeutic Classification System)
  • AHFS Therapeutic Class Tier 1 Description -- The natural language description of the first-tier category within the AHFS Therapeutic Classification System that the medication is assigned to. (See also [URSA-CORE] AHFS Pharmacologic-Therapeutic Classification System)
  • AHFS Therapeutic Class Tier 2 Description -- The natural language description of the second-tier category within the AHFS Therapeutic Classification System that the medication is assigned to. (See also [URSA-CORE] AHFS Pharmacologic-Therapeutic Classification System)
  • AHFS Therapeutic Class Tier 3 Description -- The natural language description of the third-tier category within the AHFS Therapeutic Classification System that the medication is assigned to. (See also [URSA-CORE] AHFS Pharmacologic-Therapeutic Classification System)
  • Red Book Generic Cross Reference Code -- A unique 6-digit code assigned to all products that contain the same set of active ingredients. By extracting all records containing this code, users can identify comparable products regardless of trade or generic name. (See also [URSA-CORE] Red Book Generic Formulation Code)
  • Red Book Generic Formulation Code -- A unique 6-digit code identifying drugs with common active ingredients, master dosage form, strength, and route of administration. The GFC is not manufacturer or package size specific, and can therefore be used in preparation of drug utilization reports and analysis of generic alternatives for substitution and formulary development. The GFC may also be used within pharmacy and claims administration systems as an efficient means of linking NDC numbers to clinical screening functions. (See also [URSA-CORE] Red Book Generic Cross Reference Code)
  • Quantity Dispensed -- The quantity of medication dispensed in the fill. For medications with discrete forms (e.g., tablets, capsules, etc.) this is the number of those discrete units dispensed. For non-discrete forms (e.g., solution, cream, etc.) this is some other measure of quantity, including (but not necessarily) the number of doses dispensed.
  • Days Supply -- The number of calendar days, including the date the medication was dispensed, the dispensed medication will last at the patient's intended dosage as defined in their prescription.
  • NCPDP Dispense as Written Code -- The standard 1-digit Dispense as Written (DAW) code developed and maintained by the National Council for Prescription Drug Programs (NCPDP), identifying the types of substitutions, if any, the pharmacy can make when filling the prescription; e.g., 1 = Substitution not allowed by prescriber.
  • Total Paid Amount

• Financial Fields

  • Plan Paid Amount -- The amount actually paid by the health plan to the provider for a service or product. Subtracting the plan paid amount from the total due amount typically yields the patient responsibility amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Paid Amount, Secondary Plan Paid Amount, and Tertiary Plan Paid Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively; the total paid by any and all plans on a bill is identified by the Any Plan Paid Amount field.
  • COB Paid Amount -- The total amount paid to the provider by one or more health plans other than the plan identified on the claim record as part of a "coordination of benefit" (COB) action; a COB scenario can arise when a patient has multiple concurrent plan memberships.
  • Patient Paid Amount -- The amount paid by the patient to the provider for health care services or products.

• Module Fields

  • Is Chronic Medication -- A medication meeting at least one of the following: (1) 3 or more fills over the history of the patient for this or other medications in the same AHFS Therapeutic Class ; (2) 90 or more days supply over the history of the patient for this or other medications in the same AHFS Therapeutic Class
  • Is Antidepressant -- One of the Priority Adherence Medication types; a medication classified as an antidepressant based on AHFS Therapeutic Class code or Red Book Generic Cross Reference Code. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Is Antineoplastic -- One of the Priority Adherence Medication types; a medication classified as an antineoplastic based on AHFS Therapeutic Class code. Antineoplastic drugs are medications used to treat cancer. Other names for antineoplastic drugs are anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs. (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Is Antidiabetic -- One of the Priority Adherence Medication types; a medication classified as an antidiabetic based on AHFS Therapeutic Class code or Red Book Generic Cross Reference Code as an antidiabetic of any type (insulin, oral, etc.). (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Is Oral Antidiabetic -- A child to the "Is Antidiabetic" medication type, indicates antidiabetic medications that can be taken orally as opposed other routes of administration (such as injections). Oral Antidiabetics are commonly separated from all antidiabetics for various adherence/quality measures (e.g., Stars PDC). (See also [URSA-PHARM] Antidiabetic)
  • Is Oral ACEI/ARB -- One of the Priority Adherence Medication types; indicates a medication classified as a angiotensin-converting enzyme inhibitor (ACEI) and an angiotensin receptor blocker (ARB) based on the Red Book Generic Cross Reference code and/or NDC being included in the CMS Stars measure specifications for Oral ACEI/ARB PDC measures. (See also [URSA-PHARM] Is Priority Adherence Medication, [URSA-PHARM] Active Priority Adherence Medication Type Category)
  • Is Statin -- One of the Priority Adherence Medication types; indicates a medication classified as a Statin based on the Red Book Generic Cross Reference code and/or NDC being included in the CMS Stars Statin proportion of days covered (PDC) measure value sets. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Is Beta Blocker -- One of the Priority Adherence Medication types; indicates a medication classified as a beta blocker based on the Red Book Generic Cross Reference Code classification. (See also [URSA-PHARM] Is Priority Adherence Medication)
  • Is Anticoagulant -- One of the High Risk Medication types; a medication classified as an anticoagulant based on the AHFS therapeutic class. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Is Cardiac Glycosides -- One of the High Risk Medication types; a medication classified as a cardiac glycoside based on the AHFS therapeutic class. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Is Insulin -- One of the High Risk Medication types; a medication classified as an insulin based on the AHFS therapeutic class or NDC present in the CMS Stars PDC oral anti-diabetic adherence measure specifications (used as an exclusion). (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Is Opiate Agonists -- One of the High Risk Medication types; a medication classified as an opiate agonist based on the AHFS therapeutic class. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples of full agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and others. Partial agonist opioids activate the opioid receptors in the brain, but to a much lesser degree than a full agonist. Buprenorphine is an example of a partial agonist. In clinical practice, they are used for opioid agonist maintenance therapy or withdrawal management. (See also [URSA-PHARM] Is Active Chronic Opioid Episode)
  • Is Oral Antiplatelet -- One of the High Risk Medication types; a medication classified as an oral antiplatelet based on the AHFS therapeutic class or Red Book Generic Cross Reference Code. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Is Oral Hypoglycemic -- One of the High Risk Medication types; a medication classified as a hypoglycemic based on the AHFS therapeutic class. (See also [URSA-PHARM] Is High Risk Medication, [URSA-PHARM] High Risk Medication Category)
  • Is Generic -- Derived from available information from first the claims and second Red Book NDC reference data, this flag indicates a medication created to be the same as an already marketed brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use.
  • Is Single Source -- Indicates that the medication is considered to be available from only one source, often a brand-name product with no available generic alternatives or a generic for which a single company holds the patent and has sole rights to sell to consumers. (See also [URSA-PHARM] Is Generic)
  • Ingredients Hash -- A coded value used to identify all medication fills sharing active ingredients based on the best available data. The Ingredients Hash is primarily based on mapping the NDC to the Red Book Generic Cross Reference Code but, if not found, takes the first non-missing value from (1) the active ingredients listed in the source data, (2) the label description, (3) the NDC code. (See also [URSA-PHARM] Lifetime Medication Treatment Episode ID, [URSA-CORE] Red Book Generic Cross Reference Code)

• [No Field Group]

  • Episode ID
  • Episode Start Date
  • Episode End Date
  • Episode Length Days
  • Episode Aggregate Days Supply
  • Episode Count Fills
  • Is First Fill In Episode
  • Is Last Fill In Episode
  • Episode First Prescribing Provider ID
  • Episode Last Prescribing Provider ID
  • Episode First Filling Provider ID
  • Episode Last Filling Provider ID

Terms

• Targeted Medication Therapy Episode: A continuous period of time during which the patient is in supply, or in a gap of supply fewer than 30 days, for any of the following targeted medication types: antidepressants; antineoplastics; beta blockers; antidiabetics; ACEI/ARBs; statins; high-risk medications (anticoagulants, oral antiplatelets, cardiac glycosides, opiate agonists, oral hypoglycemics, or insulin); or other chronic medications. Medications with the same active ingredients (even if they have different strengths) are considered equivalent for the purpose of constructing these episodes.

Foreign Keys

• document_id → ursa.so_ursa_pharm_meds_001.document_id
• claim_id → ursa.no_ursa_core_fin_004.claim_id
• pat_id → ursa.no_ursa_core_pat_001.pat_id
• filling_prov_id → ursa.so_ursa_pharm_prov_001.prov_id
• prescribing_prov_id → ursa.no_ursa_core_prov_001.prov_id
• lifetime_medication_treatment_episode_id → ursa.so_ursa_pharm_meds_001.lifetime_medication_treatment_episode_id