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This public use file contains formulary and pharmacy network data for Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug Plans (with the exception of employer and PACE plans). This file will be updated monthly with updates being available at the end of the first complete week of each month. This public use file is comprised of the following files: - Geographic Locator File - Includes the MA and PDP Region codes and county codes
- Plan Information File - Includes information for each plan (name, contract ID, plan ID, service area, plan type, etc.)
- Formulary File - Formulary details for each plan including NDCs, Tier Level, and indicators for Step Therapy, Quantity Limits, and Prior Authorization.
- Beneficiary Cost File - Plan level cost sharing details for preferred, non-preferred and mail order network pharmacies.
- Pharmacy Network File - NABP numbers for each network pharmacy including preferred, retail, and mail order indicators.
- Record Layout: This file includes a diagram of file linkages, plus separate data dictionaries for each of the files listed above. The record layout and data dictionary for the Formulary file are subject to change. Please check the data dictionary shipped with your order. For viewing the data dictionaries on-line, please see the Record Layout file in Downloads below.
Common data elements in each file include Contract ID, Plan ID, and Segment ID (if applicable). Use of this file will require access to the following data sources: - National Council for Prescription Drug Programs, Inc (NCPDP) data access to crosswalk the NABP unique pharmacy numbers to pharmacy names and addresses in the Pharmacy Network File.
- Drug databases such as MediSpan or First DataBank to crosswalk NDCs to drug names in the Formulary File.
TERMS AND CONDITIONS FOR USE OF PART D FORMULARY AND PHARMACY NETWORK INFORMATION The Part D Formulary and Pharmacy Network Information is a public use file being provided by the Centers for Medicare & Medicaid Services (CMS), and any use of such information by Requesting Party must be in a manner consistent with these Terms and Conditions. By requesting and using the Formulary and Pharmacy Network Information, Requesting Party agrees that it will comply with these Terms and Conditions. See full Terms and Conditions in the Downloads area below. Media: CD ROM
File Cost: $100.00 per month
Available: Monthly updates starting December 2005 The release dates for 2008 are: 10/31/07, 11/30/07, 12/31/07, 1/31/08, 2/29/08, 3/31/08, 4/30/08, 5/31/08, 6/30/08, 7/31/08, 8/31/08, 9/30/08
Page Last Modified: 07/01/2008 11:28:26 AM
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