Every U.S. formulary. One schema. Your cloud.
30,000+ commercial, Medicare Part D, Medicaid, and ACA exchange formularies — aggregated, normalized, and delivered directly into your data platform. No proprietary analytics layer required.
What Formulary Scanner is
A formulary is a payer's list of covered drugs, organized by tier (which determines patient cost-share) and annotated with utilization-management restrictions: prior authorization (PA), step therapy (ST), quantity limits (QL), age limits, and site-of-care restrictions.
Each commercial payer publishes a different formulary per plan — sometimes hundreds of plans per payer — updated at least quarterly.
Formulary Scanner turns this fragmented landscape into a single structured dataset, kept current, delivered to your cloud.
Skip the year of pipeline-building. Subscribe to the data layer, focus your team on the analytics layer.
Five data views, one consistent schema
Designed to plug into the dimensional models analytics teams already use.
Drug Coverage
drug × plan × month with tier, PA / ST / QL flags, age and dose limits, effective dates.
Plan Catalog
Plan metadata: payer, line of business, network type, geography, formulary URL, MRF reference.
Drug Reference
RxCUI, NDC, GPI, brand / generic, therapeutic class, strength, dosage form.
Coverage Changes
Diff stream: every tier change, restriction change, addition or removal with timestamps. Commercial Lite & Enterprise.
Source Provenance
For every record: source URL, retrieval timestamp, parser version, confidence score.
How it works
Three steps from raw payer publications to queryable data in your warehouse.
Ingest
We ingest raw formulary data from CMS public files, state Medicaid PDLs, and licensed commercial sources.
Normalize
We normalize, validate, and structure it into our canonical schema — drug × plan × month with full restriction flags.
Deliver
You query it directly in your Databricks workspace, Snowflake environment, or S3 bucket via AWS Data Exchange.
Delivery options
Pick the cloud you already work in. We handle the rest.
Databricks Marketplace
Native Delta Sharing. 30-day free trial auto-provisioned. Ideal for teams already running Spark or MLflow workflows.
Snowflake Marketplace
Secure Data Sharing. Instant provisioning into your Snowflake account. No ETL required.
AWS Data Exchange
Parquet delivery to your S3. Payment on your existing AWS bill. Broadest enterprise procurement reach.
The Rx MRF requirement is coming — we're building the parser now.
The Transparency in Coverage (TiC) final rule requires all non-grandfathered group health plans to publish prescription-drug machine-readable files (Rx MRFs). An HHS / DOL / Treasury RFI was issued June 2025; final enforcement specs are expected in 2026–2027.
When payers start publishing, Formulary Scanner will already have the parsing infrastructure and the schema in production — giving our customers immediate access without rebuilding pipelines.
Data freshness & SLA
Different sources, different cadences — all transparent.
| Source | Refresh cadence | Customer SLA |
|---|---|---|
| Medicare Part D (CMS) | Monthly (day 7 of month) | ≤ 7 days |
| State Medicaid PDLs | Weekly full re-publish, daily change detection | ≤ 7 days |
| ACA / Commercial | Weekly crawl with diff | ≤ 30 days |
| Rx MRF (when live) | Monthly, per regulatory cadence | ≤ 7 days |
Pricing
Subscribe via Stripe Checkout for Researcher and Commercial Lite. Enterprise is direct contract.
- Medicare Part D + 5 state Medicaid PDLs
- Drug Coverage + Plan Catalog views
- 30-day free trial via Databricks or Snowflake Marketplace
- Email support
- Monthly refresh SLA
- All 30,000+ plans across all lines of business
- All five data views, including Coverage Changes diff stream
- Weekly refresh SLA
- API access
- Priority email support
- Custom delivery and named-account support
- ≤ 7-day SLA on all sources
- SOC 2 Type II report on request
- Schema customization
- Design-partner pricing: first 5 enterprise customers receive 50% off Year 1
Built for the cloud era. Not the enterprise sales era.
How Formulary Scanner compares — factually — to traditional formulary data providers.
Traditional providers
- Proprietary analytics layer required
- Bespoke contract negotiation per deal
- Pricing on request, often six figures
- Closed schema, vendor-defined fields
- Data delivered through vendor's UI or APIs
Formulary Scanner
- Open schema documented publicly
- Marketplace-native delivery (Databricks, Snowflake, AWS)
- Transparent monthly pricing on the lower tiers
- Consumption-based options for enterprise
- Data in your warehouse — no proprietary analytics layer
Frequently asked questions
What data sources does Formulary Scanner use?
CMS public files (Medicare Part D — free, structured, monthly), state Medicaid Preferred Drug Lists (public government data), and licensed commercial sources where applicable. All sources are disclosed via the Source Provenance view.
How current is the data, and what are the refresh SLAs?
See the refresh table above. Enterprise SLA is ≤ 7 days across all sources.
Is Formulary Scanner HIPAA-compliant? Do I need a BAA?
Formulary data is plan and policy metadata — not Protected Health Information (PHI). No BAA is required. Our compliance surface is SOC 2, not HIPAA. SOC 2 Type I targeted for Month 6; Type II for Month 12.
How does data delivery work on Databricks and Snowflake?
We publish via Delta Sharing (Databricks) and Secure Data Sharing (Snowflake). You query the data directly in your existing workspace — no export, no ETL, no additional infrastructure.
What is the Coverage Changes stream and which tiers include it?
The Coverage Changes view is a diff stream of every tier change, restriction change, addition, or removal with timestamps. It's included in Commercial Lite and Enterprise tiers.
Is SOC 2 certification in place?
SOC 2 Type I is targeted for Month 6 of operations; Type II for Month 12. Enterprise customers receive the report on request.
Year 1 roadmap
Where we are and where we're going.
Ready to skip the year of pipeline-building?
Subscribe via Databricks or Snowflake Marketplace, or get in touch about Enterprise.