Skip to main content
U.S. flag

An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Skip to content
  • Feedback

    • Monthly Prescription Drug Plan Formulary and Pharmacy Network Information

    Metadata Updated: March 1, 2025

    The Monthly Prescription Drug Plan Formulary and Pharmacy Network Information files contain formulary and pharmacy network data for Medicare Prescription Drug Plans and Medicare Advantage (MA) Prescription Drug Plans (with the exception of employer and Program of All-Inclusive Care for the Elderly plans).

    Notice: CMS has identified an issue that resulted in a 15% coinsurance for plans with Defined Standard benefits to be listed rather than a 25% coinsurance in the Beneficiary Cost File under certain scenarios. This issue affected the October 2023 to November 2024 data. CMS will re-post the corrected data in batches between now and May 2025. The following files have already been corrected and re-posted:

    October 2024
November 2024

    These non-identifiable files are available on a monthly basis and are comprised of the following tables:

    Plan Information - Information such as plan name, contract ID, plan ID, service area, and plan type.
Geographic Locator - MA and Prescription Drug Plans region codes and county codes.
Basic Drugs Formulary - Formulary details for each plan including National Drug Codes (NDCs), cost share tier level, and indicators for step therapy, quantity limits, and prior authorization.
Excluded Drugs Formulary - Enhanced alternative plans may elect to provide a supplemental benefit and cover excluded drugs. File includes formulary details for excluded drugs that are covered by the plan (for enhanced alternative plans only).
Beneficiary Cost - Plan level cost sharing details for preferred, non-preferred, and mail order network pharmacies.
Pharmacy Network - National Provider Identifier (NPI) numbers for each network pharmacy including preferred, retail, and mail order indicators.
Indication Based Coverage Formulary File - Includes drugs covered based on FDA-approved indication for each plan.
Insulin Beneficiary Cost File - Plan level cost sharing details for insulin at preferred, non-preferred and mail order network pharmacies.

    These are large files and can take time to download.   

    Please read the “Agreement for Use” in the Resources section below. This document contains important information regarding timeframes for obtaining data as well as data accuracy and integrity.

    The Quarterly Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information is also available to access for the quarterly level information. 

    Please note: The Part D benefit year information for plans become available in October of the year prior. For example, year 2024 data is available in the October, November and December 2023 monthly files. Year 2024 data continues to be available in the January through September 2024 monthly files, then beginning in October of 2024 year 2025 data becomes available.

    Estimated release dates for upcoming 2025 monthly data (files reflect data for the month in which the file is released):

    2/26/25
3/26/25
4/23/25
5/21/25
6/18/25
7/30/25
8/27/25
9/24/25

    Files older than contract year 2019 can be purchased.

    Access & Use Information

    Public: This dataset is intended for public access and use. License: See this page for license information.

    Downloads & Resources

    References

    https://data.cms.gov/sites/default/files/2024-10/70a9541f-c350-43c3-a3c6-26fe428807de/Methodology-PUF-2025.pdf

    Dates

    Metadata Created Date January 19, 2024
    Metadata Updated Date March 1, 2025
    Data Update Frequency R/P1M

    Metadata Source

    Harvested from Healthdata.gov

    Other Data Resources

    Additional Metadata

    Resource Type Dataset
    Metadata Created Date January 19, 2024
    Metadata Updated Date March 1, 2025
    Publisher Centers for Medicare & Medicaid Services
    Maintainer
    Identifier https://data.cms.gov/data-api/v1/dataset/cb2a224f-4d52-4cae-aa55-8c00c671384f/data-viewer
    Data First Published 2023-12-15
    Language en-US
    Data Last Modified 2025-02-27
    Category Medicare
    Public Access Level public
    Data Update Frequency R/P1M
    Bureau Code 009:38
    Metadata Context https://project-open-data.cio.gov/v1.1/schema/catalog.jsonld
    Metadata Catalog ID https://healthdata.gov/data.json
    Schema Version https://project-open-data.cio.gov/v1.1/schema
    Catalog Describedby https://project-open-data.cio.gov/v1.1/schema/catalog.json
    Data Quality True
    Data Dictionary https://data.cms.gov/sites/default/files/2024-10/53da33d6-c110-4834-99ad-483980a07269/PUFRecordLayout-2025.pdf
    Data Dictionary Type application/pdf
    Harvest Object Id 21669e0f-becf-4645-9b7e-3b638ff24bf8
    Harvest Source Id 651e43b2-321c-4e4c-b86a-835cfc342cb0
    Harvest Source Title Healthdata.gov
    Homepage URL https://data.cms.gov/provider-summary-by-type-of-service/medicare-part-d-prescribers/monthly-prescription-drug-plan-formulary-and-pharmacy-network-information
    License https://www.usa.gov/government-works
    Program Code 009:000
    Related Documents https://data.cms.gov/sites/default/files/2024-10/70a9541f-c350-43c3-a3c6-26fe428807de/Methodology-PUF-2025.pdf
    Source Datajson Identifier True
    Source Hash a9660c0d139cde8eadc90ff1a25eb41626a64a26378f72b202d0367de8b49f73
    Source Schema Version 1.1
    Temporal 2019-01-01/2025-02-28

    Didn't find what you're looking for? Suggest a dataset here.