Part D Plans & Formularies

Plan, formulary, tier, utilization-management, member cost-sharing, pharmacy pricing, service-area, and legacy Part D benefit data.

What Vlada adds: Preserves the publisher data, normalizes schema eras and identifiers, and connects the product to compatible healthcare entities with measured join coverage.

rows: 1.65B; rows
datasets: 10; datasets
cadence: quarterly / annual; cadence
coverage: 2006-2026; coverage

Publishers: Centers for Medicare & Medicaid Services

What's inside

Part D plan drug pricing (CMS SPUF)

Plan x NDC unit-cost fact from CMS SPUF — THE BIG ONE (~43M-61M rows/quarter).

grain: One row per (contract_id, plan_id, segment_id, ndc11, days_supply, report_quarter).

1.59B rows

Part D formulary coverage (CMS SPUF)

NDC-grained Part D formulary coverage from CMS SPUF: tier_level_value, prior authorization, step therapy, quantity limits, and selected-drug flag across all MA-PD + PDP formularies.

grain: One row per (formulary_id, NDC11, report_quarter).

42.9M rows

Part D plan cost-share (CMS SPUF)

Beneficiary cost-share fact from CMS SPUF — copay/coinsurance by coverage phase x tier x days_supply.

grain: One row per (contract_id, plan_id, segment_id, coverage_level, tier, days_supply, report_quarter).

4.9M rows

Part D plan service area (CMS SPUF)

Plan x geography fact from CMS SPUF — which counties each Part D plan serves.

grain: One row per (contract_id, plan_id, segment_id, state, county_code, report_quarter).

2.4M rows

MA pbp mrx tier

Part D Rx tier detail from mrx_tier.txt, keyed by both CMS-native tier identifiers so legacy repeated rows remain distinct.

grain: Part D Rx tier-grain (mrx_tier.txt). Plan × tier. 2010+.

858.8K rows

MA pbp mrx p

Part D plan x pharmacy-tier formulary detail from mrx_p.

grain: Part D plan × pharmacy-tier formulary detail. ~27K rows/yr. Coverage: 2006-present.

623.6K rows

MA pbp mrx gap coverage

Part D coverage-gap detail keyed by the source-native MRx tier identifier.

grain: Part D coverage-gap detail. Folded into pbp_mrx in 2026. Coverage: 2006-2025.

592.3K rows

Part D formulary exclusion list (CMS SPUF)

Plan-level explicit drug-exclusion list from CMS SPUF, with tier, prior-auth, step-therapy, quantity-limit, and capped-benefit flags.

grain: One row per (contract_id, plan_id, drug_identifier, drug_identifier_type, report_quarter).

355.1K rows

MA pbp mrx

Part D Rx plan-level/group detail from mrx.txt.

grain: Part D Rx plan-grain (mrx.txt). 2010+. Insulin / IRA fields added 2026.

247.9K rows

Part D plan dimension (CMS SPUF)

The Part D plan-identity dim from CMS SPUF: the plan -> formulary bridge and carrier/plan attribution for the whole SPUF family.

grain: One row per (contract_id, plan_id, segment_id, report_quarter).

160.9K rows