Part D File Information

There are multiple files that are associated with the Part D data:

• Part D Drug Event File (PDE) Documentation - This file includes all transactions covered by Medicare prescription drug plan for both Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug Plans (MA-PDs).
  • Drug Characteristic File - variables appended to the PDE that describe the drug listed (e.g., NDC, brand and generic name)
• Formulary File Documentation - suite of three subfiles: formulary, excluded drug and Over the Counter Drug that contain information on how the plan covers the prescription drugs filled.
• Pharmacy Characteristics File Documentation - contains information about the pharmacy identified as the source of the drug for each PDE prescription fill record.
  • Pharmacy Bridge File - In 2014, CMS changed the pharmacy identifier included on the PDE changed, this file provides a crosswalk that allows tracking the same pharmacy across this transition year.
    • NOTE: Although one can track the same pharmacy over time, all pharmacy identifiers are encrypted.
• Prescriber Characteristics File Documentation - contains descriptive information for the prescriber identified in the PDE file.

View CCW’s Medicare Claims Record Layout and Codebook