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SAS Name
FRMLRY_RX_ID
This variable is a CCW-created identifier for a drug product that is found in a Part D prescription drug plan's formulary.
Part D Plans submit their formularies to CMS and identify drug products using the National Library of Medicine RxNorm Concept Unique Identifiers (RXCUIs).
There can be several drug products submitted that are the same clinical formulation (same ingredients, strength, and dosage form) but different brand names.
Each RXCUI corresponds to a unique brand name and clinical formulation. The CCW Formulary drug ID is analogous to an RXCUI.
Values: 8-digit number
The value: 99999999 indicates diabetic supplies.
Source: PDE and CMS HPMS (derived)
This variable was new in 2010.
The Formulary Characteristics Files are built from the CMS Approved Formulary Data found in the CMS' Health Plan Management System (HPMS) where a proxy NDC is assigned to each RXCUI. The proxy NDC for each drug product is mapped to a unique FirstDataBank brand name and proprietary clinical formulation identifier which is then assigned a CCW sequence number (FRMLRY_RX_ID). In order for a PDE record to link to the Formulary Characteristics Files, the drug product on the PDE must map to a FRMLRY_RX_ID in the formulary associated with the plan of record.
Researchers interested in linking the Utilization Management (UM) variables (tier, step therapy, quantity limits, and prior authorization) to the PDE data will need to link the FORMULARY_ID and FRMLRY_RX_ID to the Formulary Characteristics File to get the UM variables.