Improve Medication Therapy with Medicare Claims Data

AB2D is an Application Programming Interface (API) for Prescription Drug Plan (PDP) sponsors. Offered by the Centers for Medicare & Medicaid Services (CMS), AB2D provides Parts A and B claims data for a holistic view into patients' health.

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Code repo

Use cases for the AB2D API

Target MTM program enrollees

Identify Medication Therapy Management (MTM) enrollees by using data for a more thorough search capability.

Enhance MTM consultations

Leverage insights from enrollee medical histories for more effective services.

Boost health outcomes

Enhance MTM enrollee health and program results by improving medication use and adherence.

Prevent fraud, waste, and abuse

Identify suspicious activity from providers or suppliers through access to mass data.

Learn more about use cases

Read the white paper on AB2D for MTM programs

Using the data

AB2D is an Application Programming Interface using Fast Healthcare Interoperability Resources (FHIR) in NDJSON format. It provides access to data including:

enrollee identifiers
diagnosis codes
dates and times of service

Learn about the data

What are permitted uses of the data?

The final rule specifies that data may be used for:

Optimizing therapeutic outcomes through improved medication use
Improving care coordination
Other purposes [that qualify] as “fraud and abuse detection or compliance activities”

The following uses are not permitted:

Inform coverage determinations under Part D;
Conduct retroactive reviews of medically accepted indication(s) determinations;
Facilitate enrollment changes to a different prescription drug plan or an MA-PD plan offered by the same parent organization; or
Inform marketing of benefits

Learn more about AB2D