CMS Data Research Catalog
Comprehensive catalog of CMS Data Research Dataset tables
Browse available CMS Research Data tables below. Each entry includes description and metadata.
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Part C&D Plan Crosswalk
Description: Essential mapping resource that links Medicare Advantage (Part C) and Prescription Drug Plans (Part D) across different contract and plan identifiers. This data enables tracking of plan relationships, mergers, and transitions over time. Key attributes include contract IDs, plan IDs, organization names, and crosswalk effective dates. Analysts can leverage this data to maintain continuity in member analytics during plan changes, track organizational consolidations, and ensure accurate historical comparisons across plan evolution.
Table Name: plan_crosswalks
Enrollment by Contract
Description: Comprehensive monthly enrollment metrics at the contract level for all Medicare organization types including MA, PDP, Cost Plans, and PACE. Key data points include contract ID, organization name, plan type, and monthly enrollment counts. This foundational dataset enables market share analysis, growth tracking, competitive intelligence, and strategic planning. Business users can identify enrollment trends, seasonal patterns, and monitor competitor performance across different Medicare products.
Table Name: monthly_enrollment_by_contract
MA Contract Service Area
Description: Geographic coverage mapping for Medicare Advantage contracts at the state and county level. Includes contract ID, state codes, county codes, and service area effective dates for all MA organization types. This critical dataset supports network adequacy analysis, market expansion planning, competitive landscape assessment, and regulatory compliance. Healthcare organizations can identify underserved markets, evaluate geographic overlap with competitors, and optimize service area strategies.
Table Name: ma_contract_service_area_by_state_county
MA Enrollment by SCC
Description: Granular Medicare Advantage enrollment data segmented by state, county, and contract. Features monthly enrollment counts, demographic breakdowns, and geographic identifiers for precise market analysis. This dataset empowers local market penetration studies, county-level competitive analysis, and targeted marketing strategies. Healthcare strategists can identify high-growth counties, assess local market dominance, and optimize resource allocation. Privacy-protected version available excluding small cell sizes (≤10 enrollees) for public reporting.
Table Name: monthly_ma_enrollment_by_state_county_contract
MA Enrollment by SCP
Description: Medicare Advantage enrollment metrics organized by state, county, and specific plan benefit package types (HMO, PPO, PFFS, SNP, etc.). Includes enrollment counts, plan type indicators, and geographic identifiers enabling detailed product performance analysis. This dataset supports product portfolio optimization, benefit design decisions, and market positioning strategies. Analysts can evaluate which plan types resonate in specific markets and track consumer preferences across different benefit designs.
Table Name: monthly_ma_enrollment_by_state_county_plan_type
MA State/County Penetration
Description: Market penetration analytics showing Medicare Advantage adoption rates as a percentage of total Medicare eligibles by state and county. Includes total Medicare beneficiaries, MA enrolled members, penetration percentages, and year-over-year growth metrics. Essential for market opportunity assessment, expansion prioritization, and competitive benchmarking. Healthcare executives can identify high-potential markets, track penetration trends, and forecast growth opportunities in underserved areas.
Table Name: ma_state_county_penetration
Monthly Enrollment by CPSC
Description: Most granular enrollment dataset available, providing monthly metrics at the intersection of contract, plan, state, and county for all Medicare organization types. Comprehensive attributes include enrollment counts, plan characteristics, geographic details, and temporal data. This master dataset enables sophisticated multi-dimensional analysis, precise market segmentation, and detailed performance tracking. Ideal for advanced analytics, predictive modeling, and strategic decision support.
Table Name: monthly_enrollment_by_contract_plan_state_county
Monthly Enrollment by CPSC (Enrollment Detail)
Description: Extended enrollment detail dataset with comprehensive monthly metrics at contract, plan, state, and county levels. Includes additional demographic segmentation, enrollment type indicators, and historical tracking fields. This enriched dataset supports deep-dive enrollment analytics, member movement studies, and retention analysis. Healthcare data scientists can build predictive models, analyze enrollment patterns, and identify factors driving member decisions across different markets and time periods.
Table Name: monthly_enrollment_by_contract_plan_state_county__enrollment
Monthly Enrollment by Plan
Description: Plan-level enrollment tracking for all Medicare products with monthly snapshots. Key fields include contract ID, plan ID, organization details, plan type, and enrollment counts. This dataset facilitates plan performance monitoring, product lifecycle analysis, and strategic portfolio management. Product managers can track individual plan success, identify underperforming offerings, and make data-driven decisions about plan continuation or modification.
Table Name: monthly_enrollment_by_plan
Monthly Enrollment by State
Description: State-level Medicare market overview showing total Medicare eligibles, Medicare Advantage enrollment, standalone PDP enrollment, and other Medicare product enrollment. Includes penetration rates, market share metrics, and growth indicators by state. This high-level dataset supports executive dashboards, state regulatory reporting, and macro market trend analysis. Strategic planners can assess state-by-state opportunities and align resources with market potential.
Table Name: monthly_enrollment_by_state
PBP Benefits - 2025
The PBP Benefits data has been organized into four specific tables:
Benefits Data - Plan Information
Description: Comprehensive plan directory for Medicare Advantage and Part D offerings including plan names, marketing names, organization contacts, service area details, SNP designations, and star ratings. Critical attributes include plan type classifications, network types, prior authorization indicators, and referral requirements. This foundational dataset enables competitive intelligence, plan comparison tools, member shopping experiences, and regulatory compliance tracking. Updated annually with mid-year updates for new plans.
Table Name: benefits_data__plan_info
Benefits Data - Covered Services
Description: Detailed catalog of covered medical services, supplemental benefits, and preventive care offerings by plan. Includes service categories, coverage limits, prior authorization requirements, cost-sharing tiers, and benefit descriptions. Rich dataset for benefit design analysis, competitive differentiation studies, and member value proposition development. Healthcare consultants can benchmark benefit offerings, identify market trends in supplemental benefits, and optimize benefit packages for target demographics.
Table Name: benefits_data__services
Benefits Data - Part D Drug Coverage
Description: Comprehensive prescription drug benefit structures including formulary design, tier placement, cost-sharing amounts across coverage phases (deductible, initial coverage, gap, catastrophic), and pharmacy network details. Key fields include deductible amounts, copay/coinsurance by tier, coverage gap discounts, and specialty drug requirements. Essential for pharmacy benefit analysis, formulary optimization, member out-of-pocket modeling, and competitive drug benefit positioning.
Table Name: benefits_data__part_d
Benefits Data - Premiums & Deductibles
Description: Financial structure of Medicare plans including monthly premiums, medical deductibles, drug deductibles, maximum out-of-pocket limits, and cost-sharing tiers. Contains premium variations by region, deductible types (combined vs. separate), and MOOP amounts. Critical for pricing analysis, affordability studies, value proposition development, and financial modeling. Actuaries and pricing teams can benchmark competitive positioning and optimize plan financial designs.
Table Name: benefits_data__premiums_deductibles
PDP Contract Service Area
Description: Geographic coverage mapping for standalone Prescription Drug Plans (PDPs) and employer-direct PDPs at state and county granularity. Includes contract identifiers, geographic codes, and service area effective dates. Supports Part D market analysis, pharmacy network planning, and PDP competitive assessments. Pharmaceutical manufacturers and PBMs can identify PDP coverage patterns and optimize market access strategies.
Table Name: pdp_contract_service_area_by_state_county
PDP Enrollment by SCC
Description: Granular standalone Part D enrollment metrics by state, county, and contract. Features monthly enrollment counts, LIS/non-LIS breakdowns, and auto-enrollment indicators. Enables targeted Part D market analysis, Low-Income Subsidy (LIS) population tracking, and regional PDP performance assessment. Pharmaceutical stakeholders can evaluate PDP market share for formulary negotiations and identify high-value geographic markets. Privacy-protected version available for public use.
Table Name: monthly_pdp_enrollment_by_state_county_contract
PDP Enrollment by SCP
Description: Part D standalone enrollment segmented by state, county, and plan characteristics including basic vs. enhanced benefit designs. Tracks enrollment patterns, benefit type preferences, and geographic distribution of PDP membership. Valuable for understanding consumer preferences between basic and enhanced drug coverage, regional variations in Part D choices, and market opportunities for differentiated PDP products.
Table Name: monthly_pdp_enrollment_by_state_county_plan_type
PDP State/County Penetration
Description: Standalone Part D market penetration analytics showing PDP adoption rates among Medicare beneficiaries without Medicare Advantage. Includes total Part D eligibles, PDP enrollment, penetration percentages, and LIS enrollment rates by geography. Critical for assessing Part D market saturation, identifying growth opportunities in underserved areas, and understanding the interplay between MA-PD and standalone PDP markets.
Table Name: pdp_state_county_penetration
SNP Comprehensive Report
Description: Specialized enrollment tracking for Special Needs Plans (SNPs) including Chronic Condition (C-SNP), Dual Eligible (D-SNP), and Institutional (I-SNP) categories. Contains plan-level enrollment counts, SNP type designations, condition-specific details for C-SNPs, and eligibility criteria. Essential for analyzing vulnerable population coverage, tracking SNP market growth, and developing targeted care management programs. Healthcare organizations can identify opportunities in specialized care delivery and assess SNP program performance.
Table Name: special_needs_plan_snp_data
State Service Area
Description: High-level geographic footprint showing which states each Medicare contract operates in, covering all organization types. Includes contract ID, organization name, state codes, and partial/full state coverage indicators. Facilitates multi-state operator analysis, geographic expansion tracking, and regional market concentration studies. Strategic planners can quickly assess organizational geographic reach and identify potential partnership or acquisition targets based on complementary state coverage.
Table Name: state_service_area
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