Methods and systems for drug interaction review are described. In an example embodiment, a prescription request is received for a prescription drug. The prescription drug is associated with a prescription. A determination that the prescription drug is a controlled substance is made. Pharmacy claims data is analyzed to determine whether past claims adjudication data is associated with a patient controlled substance identifier. The patient controlled substance identifier is associated with a patient that has been prescribed the prescription drug through the prescription without identifying the patient as being a member of a benefit manager. The prescription request is evaluated based on a determination that the past claims adjudication data is associated with the patient controlled substance identifier. A notification is generated based on evaluation of the prescription request. Additional methods and systems are disclosed.