OBJECTIVES: To evaluate the extent of excess NHI-covered medications in China Medical University Hospital (CMUH), as the surrogate indicator of inappropriate prescribing and medication practices. METHODS: Those patients who have visited outpatient units in CMUH ³ for 50% of all outpatient visits were assigned as CMUH loyal patients by Bureau of NHI in Taiwan. They have received Integrated Medical Care (IMC) services in CMUH since December 2009. Patients who have visited outpatient units in CMUH, including those in IMC services, were encouraged to recycle their excess prescription medications to the Department of Pharmacy and learn about proper medication use and its disposal during July 2011 to February 2012. Those retrieved prescription medications were classified based upon their clinical applications and checked for their reimbursed cost using information obtained from the Bureau of NHI. The differences during implementation period between IMC service group and usual care (UC) group were compared using Chi-squaredtest and t-tests.  RESULTS: While 32 patients in IMC group and 15 in the UC group recycled their excess medications, more patients in the IMC group had coronary artery disease (p=0.03). Although IMC group have made more outpatient visits significantly than UC group (29±24 vs. 9±9, p= 0.004), their inpatient visits in CMUH were similar. The average pill counts were 433±119 versus 223±60 (p= 0.03) and cost of excess prescription medication were 2,219±607 versus 2,126±950 NTD in IMC and UC group, respectively. While HTN, DM and hyperlipidemia were the three major diseases in both groups, those agents for cardiovascular disease and DM accounted for 39% and 15% of all estimated cost of excess medication. CONCLUSIONS: With the substantial excess, NHI-covered medications for chronic illness among CMUH outpatients, it is necessary to come up with workable strategies to enhance appropriate prescribing and medication use in outpatient units.