Monthly Prescription Drug Plan Formulary and Pharmacy Network Information

Description

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).   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, prior authorization, and a newly added Selected Drug flag. 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, and brand, generic, and selected drug dispensing fees for 30/60/90 days supply, respectively. Indication Based Coverage Formulary File - Includes drugs covered based on FDA-approved indication for each plan. Insulin Beneficiary Cost File - Plan level copay and coinsurance amounts 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 2026 data is available in the October, November and December 2025 monthly files. Year 2026 data continues to be available in the January through September 2026 monthly files, then beginning in October of 2026 year 2027 data becomes available. Estimated release dates for upcoming 2025 and 2026 monthly data (files reflect data for the month in which the file is released): 12/17/25 1/28/26 2/25/26 3/25/26 4/22/26 5/20/26 6/17/26 7/29/26 8/26/26 9/23/26 Files older than contract year 2019 can be purchased.

Resources

Name Format Description Link
57 2023_20220924.zip https://data.cms.gov/sites/default/files/2023-11/0850cde2-c51a-4225-a66f-93652a947554/2023_20220924.zip
57 2022_20220603.zip https://data.cms.gov/sites/default/files/2023-11/cf3c822b-8333-4e7c-8e0e-4b873369d855/2022_20220603.zip
57 2022_20220506.zip https://data.cms.gov/sites/default/files/2023-11/3cfde40f-40ad-44cc-8b47-c6f3fb7d050b/2022_20220506.zip
57 2021_20210702.zip https://data.cms.gov/sites/default/files/2023-11/4fe4805d-63e4-4bb4-af59-b0314685688f/2021_20210702.zip
57 2021_20210409.zip https://data.cms.gov/sites/default/files/2023-11/ccf7c20b-de01-480e-a629-3a4b22e2f980/2021_20210409.zip
57 2021_20210226.zip https://data.cms.gov/sites/default/files/2023-11/c2236004-b650-4384-9db5-c5e9c9ce46a6/2021_20210226.zip
57 2021_20210129.zip https://data.cms.gov/sites/default/files/2023-11/379cb591-36d9-4a48-af75-7ec84dd8596e/2021_20210129.zip
57 2021_20201204.zip https://data.cms.gov/sites/default/files/2023-11/d8c0847f-3f80-446e-a0dc-015285a482ec/2021_20201204.zip
57 2019_20190508.zip https://data.cms.gov/sites/default/files/2023-11/8d112636-ebd5-4342-a496-3254e72a83b6/2019_20190508.zip
57 2019_20190227.zip https://data.cms.gov/sites/default/files/2023-11/cfc95300-881a-439d-8f00-7ae7eba2a051/2019_20190227.zip
57 2019_20190102.zip https://data.cms.gov/sites/default/files/2023-11/4a188c5d-72f6-46e5-8886-067b95895f44/2019_20190102.zip
57 2022_20211105.zip https://data.cms.gov/sites/default/files/2023-11/0578b5c0-ed3b-46da-9488-3ea0fd37d57e/2022_20211105.zip
57 2020_20200228.zip https://data.cms.gov/sites/default/files/2023-11/d8e09181-8809-4605-ad29-3254aba9ba4f/2020_20200228.zip
57 2024_20240222.zip https://data.cms.gov/sites/default/files/2024-02/e5d07bf5-953c-4b43-acdc-e1ee57bfa759/2024_20240222.zip
57 2024_20231018.zip https://data.cms.gov/sites/default/files/2023-10/c412f770-2494-4000-ac78-cd10986968d6/2024_20231018.zip
57 2020_20200131.zip https://data.cms.gov/sites/default/files/2023-11/ce4b0026-c2a8-49ce-b530-3a2fc1367451/2020_20200131.zip
57 2024_20240530.zip https://data.cms.gov/sites/default/files/2024-05/858f857a-3d4f-423c-843f-d3b40b6d9715/2024_20240530.zip
57 2022_20211231.zip https://data.cms.gov/sites/default/files/2023-11/eb622512-d36a-46c8-9b93-ff7b3df41da5/2022_20211231.zip
57 2020_20200410.zip https://data.cms.gov/sites/default/files/2023-11/c90406bc-6cd2-4fce-8a93-3532d3f2513f/2020_20200410.zip
57 2024_20240418.zip https://data.cms.gov/sites/default/files/2024-04/d01ea5fa-3d87-48d8-b817-c68adfddb34d/2024_20240418.zip
57 2020_20200911.zip https://data.cms.gov/sites/default/files/2023-11/1cc66b82-9b93-4489-b023-967a74206d5c/2020_20200911.zip
57 2020_20200731.zip https://data.cms.gov/sites/default/files/2023-11/afd9ab57-1482-49b2-b245-08415007c519/2020_20200731.zip
57 2020_20191206.zip https://data.cms.gov/sites/default/files/2023-11/5cc9c4ea-b780-4bc5-8427-907f5493ef56/2020_20191206.zip
57 2020_20191108.zip https://data.cms.gov/sites/default/files/2023-11/8a29f9d6-fdf2-4241-8631-24bab8b9c114/2020_20191108.zip
57 2019_20190327.zip https://data.cms.gov/sites/default/files/2023-11/14b1226d-fdae-44cc-8c68-25b3fd1da4ce/2019_20190327.zip
57 2024_20231116.zip https://data.cms.gov/sites/default/files/2023-12/3bee0a79-f692-468b-999e-b5b4d18de0bd/2024_20231116.zip
57 2024_20240321.zip https://data.cms.gov/sites/default/files/2024-03/9e2e1192-a722-46ab-9059-771e10567129/2024_20240321.zip
57 2024_20240111.zip https://data.cms.gov/sites/default/files/2024-01/54c2ec14-260d-4807-bdac-08345e0d6cd9/2024_20240111.zip
57 2024_20231214.zip https://data.cms.gov/sites/default/files/2023-12/8d417dfb-14df-4128-b8b6-cec049762042/2024_20231214.zip
57 2024_20240613.zip https://data.cms.gov/sites/default/files/2024-06/95f97574-af2d-4bf6-ac7f-023c3fa4c83d/2024_20240613.zip
57 2024_20250430_JUL2024.zip https://data.cms.gov/sites/default/files/2025-05/7301679a-0661-4ab9-a3ff-5ff23ef23957/2024_20250430_JUL2024.zip
57 2023_20230811.zip https://data.cms.gov/sites/default/files/2023-11/aa4d3589-dcdd-477b-89fc-6f26f861c323/2023_20230811.zip
57 2023_20221104.zip https://data.cms.gov/sites/default/files/2023-11/138570ac-4a3e-476f-9284-9a59b7d97df2/2023_20221104.zip
57 2021_20210910.zip https://data.cms.gov/sites/default/files/2023-11/313f3ad0-8412-432c-acf6-f46175ace422/2021_20210910.zip
57 2021_20210507.zip https://data.cms.gov/sites/default/files/2023-11/804ba980-a54e-46ea-bc53-20c3904f172a/2021_20210507.zip
57 2021_20200928.zip https://data.cms.gov/sites/default/files/2023-11/99d54385-25fc-448e-af85-668b81ef91ec/2021_20200928.zip
57 2020_20200703.zip https://data.cms.gov/sites/default/files/2023-11/3d8d60a6-d132-4490-ac49-d673d33f0844/2020_20200703.zip
57 2020_20200605.zip https://data.cms.gov/sites/default/files/2023-11/59c89d24-1c2a-47f6-bf02-54ec87904b73/2020_20200605.zip
57 2020_20200508.zip https://data.cms.gov/sites/default/files/2023-11/751c67d2-5ea4-4a8a-9350-8d1ca522018f/2020_20200508.zip
57 2020_20190920.zip https://data.cms.gov/sites/default/files/2023-11/5b87864f-0d5f-45ae-8ef7-0755fa65c97e/2020_20190920.zip
57 2019_20190828.zip https://data.cms.gov/sites/default/files/2023-11/61eaab5f-bf01-4022-b005-b7b49a085286/2019_20190828.zip
57 2019_20190605.zip https://data.cms.gov/sites/default/files/2023-11/7cf83c73-3703-43b4-8a2a-01ea6ed670db/2019_20190605.zip
57 2025_20250515.zip https://data.cms.gov/sites/default/files/2025-05/ec7d5929-ba13-4a1a-8f4f-3af5034b7a0c/2025_20250515.zip
57 2025_20250417.zip https://data.cms.gov/sites/default/files/2025-04/b3e5f38b-502d-4ab8-add4-78651e2bfe68/2025_20250417.zip
57 2025_20250220.zip https://data.cms.gov/sites/default/files/2025-02/2cef8337-fdb7-46fd-bda7-5d926d3b7785/2025_20250220.zip
57 2025_20250123.zip https://data.cms.gov/sites/default/files/2025-01/b41e18c0-2249-490f-a57b-5ed085e03baf/2025_20250123.zip
57 2025_20241212.zip https://data.cms.gov/sites/default/files/2024-12/6258bcc2-9d95-4477-8c66-b43a7bc57c23/2025_20241212.zip
57 2025_20241219_Nov2024.zip https://data.cms.gov/sites/default/files/2024-12/bb6379c7-c39f-4c6c-9f99-58e58065668b/2025_20241219_Nov2024.zip
57 2024_20250331_MAY2024.zip https://data.cms.gov/sites/default/files/2025-04/6f20c5a2-94a5-4734-8be0-1851b2f72ccc/2024_20250331_MAY2024.zip
57 2024_20250331_APR2024.zip https://data.cms.gov/sites/default/files/2025-04/f1dfb226-90b3-49a8-af0b-321e1758ad02/2024_20250331_APR2024.zip
57 2024_20250331_MAR2024.zip https://data.cms.gov/sites/default/files/2025-04/6645b2dd-1903-4074-b39a-3f618894051f/2024_20250331_MAR2024.zip
57 2024_20250131_Dec2023.zip https://data.cms.gov/sites/default/files/2025-01/df39a477-5d55-4770-a11e-f03eb9c6e2de/2024_20250131_Dec2023.zip
57 2023_20230908.zip https://data.cms.gov/sites/default/files/2023-11/df324831-85ef-469f-a52c-45937d09208f/2023_20230908.zip
57 2023_20230630.zip https://data.cms.gov/sites/default/files/2023-11/659f4425-12fb-4197-ad83-f8e424a9056c/2023_20230630.zip
57 2023_20230602.zip https://data.cms.gov/sites/default/files/2023-11/4e2e968f-41c1-43bf-a642-42c86c3e11b3/2023_20230602.zip
57 2023_20230505.zip https://data.cms.gov/sites/default/files/2023-11/2ab90b80-b8f4-4eab-b6db-eba3b2a2a64b/2023_20230505.zip
57 2023_20230407.zip https://data.cms.gov/sites/default/files/2023-11/f3f63420-0cdc-41af-adbf-74fcb57f6888/2023_20230407.zip
57 2023_20221230.zip https://data.cms.gov/sites/default/files/2023-11/f4c11ce6-970d-487e-b03a-f6ec75b4ba00/2023_20221230.zip
57 2023_20221202.zip https://data.cms.gov/sites/default/files/2023-11/73fd9296-51ce-4072-81c1-82bfd4dae39c/2023_20221202.zip
57 2022_20220909.zip https://data.cms.gov/sites/default/files/2023-11/78be4985-1061-412f-8186-f370189e7430/2022_20220909.zip
57 2022_20220729.zip https://data.cms.gov/sites/default/files/2023-11/a1c31e00-f02c-4fea-b2a0-dd61677bdbcb/2022_20220729.zip
57 2022_20220408.zip https://data.cms.gov/sites/default/files/2023-11/49c5af4b-9625-4ac0-bd75-d75499de2d5d/2022_20220408.zip
57 2022_20220311.zip https://data.cms.gov/sites/default/files/2023-11/28a9c246-7484-4ed7-a8db-32bfc7336f3a/2022_20220311.zip
57 2022_20220211.zip https://data.cms.gov/sites/default/files/2023-11/938482fe-a523-4983-abbf-6739ebc3d6f2/2022_20220211.zip
57 2022_20210926.zip https://data.cms.gov/sites/default/files/2023-11/0089f6ea-4309-4686-be29-d4532da0db00/2022_20210926.zip
57 2020_20200103.zip https://data.cms.gov/sites/default/files/2023-11/ed2f7f92-ac9f-480c-8280-b9a10037953a/2020_20200103.zip
57 2019_20190130.zip https://data.cms.gov/sites/default/files/2023-11/a995a2bd-f896-45bf-addd-44facfcbe1b4/2019_20190130.zip
57 2025_20250918.zip https://data.cms.gov/sites/default/files/2025-09/2e433d96-8f6c-441f-88bd-ce68d11911b1/2025_20250918.zip
57 2025_20250821.zip https://data.cms.gov/sites/default/files/2025-08/c2c12def-0602-4165-9860-20bda749a900/2025_20250821.zip
57 2025_20250724.zip https://data.cms.gov/sites/default/files/2025-07/0f4753e2-ea08-477b-9f27-c97f15bd00fa/2025_20250724.zip
57 2025_20250612.zip https://data.cms.gov/sites/default/files/2025-06/0b76f2eb-35d1-4931-82ef-548161dd3796/2025_20250612.zip
57 2024_20250430_JUN2024.zip https://data.cms.gov/sites/default/files/2025-05/89fb4f07-ff1f-40e3-b8fd-172b8d0c9ff0/2024_20250430_JUN2024.zip
57 2024_20250131_Nov2023.zip https://data.cms.gov/sites/default/files/2025-01/aae877a9-335c-43dd-b1a0-e649742d1444/2024_20250131_Nov2023.zip
57 2024_20250131_Oct2023.zip https://data.cms.gov/sites/default/files/2025-01/333d554e-d4db-4bff-ac69-80068c59953c/2024_20250131_Oct2023.zip
57 2023_20230310.zip https://data.cms.gov/sites/default/files/2023-11/ebe9ea93-b210-45b3-a81f-fd5e867b3c93/2023_20230310.zip
57 2023_20230210.zip https://data.cms.gov/sites/default/files/2023-11/345e8284-9a21-4987-91a8-01beae73b695/2023_20230210.zip
57 2022_20220701.zip https://data.cms.gov/sites/default/files/2023-11/b82114ef-4dfe-4ad7-8c7a-3d89cad470b6/2022_20220701.zip
57 2022_20211203.zip https://data.cms.gov/sites/default/files/2023-11/fdd4cd90-fb20-47f7-9393-1c16858757e4/2022_20211203.zip
57 2021_20210730.zip https://data.cms.gov/sites/default/files/2023-11/f7ba26c3-0ff5-4cff-affc-974b9a6f3986/2021_20210730.zip
57 2021_20210604.zip https://data.cms.gov/sites/default/files/2023-11/2efc6658-3e84-4a57-bc05-752dec490fa9/2021_20210604.zip
57 2021_20210101.zip https://data.cms.gov/sites/default/files/2023-11/6df5668f-6259-4386-afd7-27d63e40b8b2/2021_20210101.zip
57 2021_20201106.zip https://data.cms.gov/sites/default/files/2023-11/db288d4b-8cdb-4483-9924-6c005bfbe90d/2021_20201106.zip
57 2019_20190731.zip https://data.cms.gov/sites/default/files/2023-11/143b48c7-ba26-4b7b-8cfb-271468e637ac/2019_20190731.zip
57 2019_20190703.zip https://data.cms.gov/sites/default/files/2023-11/65b17031-c664-4c98-93b7-746a3d5603dc/2019_20190703.zip
57 2026_20260122.zip https://data.cms.gov/sites/default/files/2026-01/5fbb3f65-72cc-49db-a13e-91c4dbe0b883/2026_20260122.zip
57 2026_20251210.zip https://data.cms.gov/sites/default/files/2025-12/a2809440-740b-4e2e-a3da-eb7a590010a5/2026_20251210.zip
57 2026_20251114.zip https://data.cms.gov/sites/default/files/2025-11/c040c52e-b2c7-4868-b42f-f4a1c5c8f935/2026_20251114.zip
57 2026_20251020.zip https://data.cms.gov/sites/default/files/2025-10/7347d364-e282-48c8-88a2-818f2a56571b/2026_20251020.zip
57 2025_20250320.zip https://data.cms.gov/sites/default/files/2025-03/482cd695-a618-4723-872c-6963f22642f6/2025_20250320.zip
57 2025_20241219_Oct2024.zip https://data.cms.gov/sites/default/files/2024-12/0be15bc4-f63d-484a-8c40-4810b35c91aa/2025_20241219_Oct2024.zip
57 2024_20250430_SEP2024.zip https://data.cms.gov/sites/default/files/2025-05/74f1765a-fcac-41b7-8153-197542c051c3/2024_20250430_SEP2024.zip
57 2024_20250430_AUG2024.zip https://data.cms.gov/sites/default/files/2025-05/86d332b6-16cf-4118-8627-ff085e1856ff/2024_20250430_AUG2024.zip
57 2024_20250228_Feb2024.zip https://data.cms.gov/sites/default/files/2025-02/c67d7556-8870-4e86-aeab-32a62867dd74/2024_20250228_Feb2024.zip
57 2024_20250228_Jan2024.zip https://data.cms.gov/sites/default/files/2025-02/8fcc8df5-e6b3-4381-80ff-308b40f442d9/2024_20250228_Jan2024.zip

Tags

  • drugs
  • medicare-prescription-drug
  • medicare
  • all-other-provider-care-types
  • health-care-use-payments
  • medicare-advantage

Topics

Categories