{"uid":"cap_dxdHPYJYUOHNVpxeqBDZn","slug":"medicare-part-d-drug-coverage-lookup-by-county-3f0c76d4","name":"Medicare Part D Drug Coverage Lookup by County","description":"Which Medicare Part D plans in this county cover this drug, at what tier and cost? Every PDP and Medicare Advantage drug plan with tier, prior authorization, step therapy, quantity limit, premium and copay, plan years 2026 and 2027, computed by Distill from CMS’s monthly formulary files. Updated monthly. $0.02 per call (x402, USDC on Base); 3 free calls a day.","url":"https://data.spencermcw.com/v1/medicare/partd/coverage?utm_source=zero.xyz","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET"],"type":"string"},"queryParams":{"type":"object","properties":{"ndc":{"type":"string","pattern":"^\\d{11}$"},"kind":{"enum":["pdp","ma","all"],"type":"string"},"limit":{"type":"integer","maximum":100,"minimum":1},"rxcui":{"type":"string","pattern":"^\\d{1,10}$"},"state":{"type":"string","pattern":"^[A-Za-z]{2}$"},"county":{"type":"string","maxLength":60,"minLength":2},"plan_year":{"type":"integer","maximum":2100,"minimum":2000},"county_code":{"type":"string","pattern":"^\\d{5}$"}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object","properties":{"data":{"type":"object","required":["plan_year","file_date","drug","location","plans_in_area","plans_covering","plans"],"properties":{"drug":{"type":"object","required":["rxcui","ndc"],"properties":{"ndc":{"type":["string","null"]},"rxcui":{"type":"string"}},"additionalProperties":false},"plans":{"type":"array","items":{"type":"object","required":["plan","plan_name","contract_name","kind","snp","premium","deductible","drug","cost_30_day"],"properties":{"snp":{"type":["string","null"]},"drug":{"type":"object","required":["tier","prior_authorization","step_therapy","quantity_limit","negotiated_drug","terms_vary_by_ndc"],"properties":{"tier":{"type":"integer","maximum":9007199254740991,"minimum":-9007199254740991},"step_therapy":{"type":"boolean"},"quantity_limit":{"anyOf":[{"type":"object"},{"type":"null"}]},"negotiated_drug":{"type":"boolean"},"terms_vary_by_ndc":{"type":"boolean"},"prior_authorization":{"type":"boolean"}},"additionalProperties":false},"kind":{"type":"string"},"plan":{"type":"string"},"premium":{"type":["string","null"]},"plan_name":{"type":"string"},"deductible":{"type":["string","null"]},"cost_30_day":{"anyOf":[{"type":"object","required":["tier","specialty","deductible_applies","preferred_retail","standard_retail","preferred_mail","standard_mail"],"properties":{"tier":{"type":"integer","maximum":9007199254740991,"minimum":-9007199254740991},"specialty":{"type":"boolean"},"standard_mail":{"type":"object"},"preferred_mail":{"type":"object"},"standard_retail":{"type":"object"},"preferred_retail":{"type":"object"},"deductible_applies":{"type":"boolean"}},"additionalProperties":false},{"type":"null"}]},"contract_name":{"type":"string"}},"additionalProperties":false}},"location":{"type":"object","required":["county_code","state","county","ma_region","pdp_region"],"properties":{"state":{"type":"string"},"county":{"type":"string"},"ma_region":{"type":"string"},"pdp_region":{"type":"string"},"county_code":{"type":"string"}},"additionalProperties":false},"file_date":{"type":"string"},"plan_year":{"type":"integer","maximum":9007199254740991,"minimum":-9007199254740991},"plans_in_area":{"type":"integer","maximum":9007199254740991,"minimum":-9007199254740991},"plans_covering":{"type":"integer","maximum":9007199254740991,"minimum":-9007199254740991}},"additionalProperties":false}}}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.02","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.02/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.02","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.02","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_w0oHyECrMJGZqJDfUUv9U","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.02","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Returns all Medicare Part D plans (PDP and Medicare Advantage) covering a specific drug in a given county, with tier, prior authorization, step therapy, quantity limit, premium, and copay details for 2026 and 2027.","exampleAgentPrompt":"Which Medicare Part D plans cover Ozempic (NDC 00169430301) in Travis County, Texas for 2026, and what tier and copay does each plan charge?","exampleUseCases":[{"title":"Medicare plan comparison for new enrollee","prompt":"My mom is turning 65 and takes Eliquis daily — can you look up which Medicare Part D plans in Orange County, California cover it for 2026 and show me the tier and monthly premium for each one?"},{"title":"Prior authorization check for expensive drug","prompt":"I need to know if any Medicare Part D PDP plans in Cook County, Illinois cover semaglutide without requiring prior authorization in 2027 — and what those plans charge per month."},{"title":"Lowest-cost formulary tier search","prompt":"Find all Medicare Advantage drug plans in King County, Washington that cover atorvastatin in 2026, sorted by which ones have it on the lowest tier with no step therapy requirements."}],"resultDescription":"A JSON object listing the drug identifiers (RxCUI, NDC), location details, total plans in the area, how many plans cover the drug, and an array of matching plans each with: plan ID, plan name, contract name, plan type (PDP or MA), SNP status, monthly premium, deductible, and drug-specific details (formulary tier, prior authorization flag, step therapy flag, quantity limit, whether it is a negotiated drug, and 30-day cost sharing amounts).","failureModes":["Invalid or unrecognized NDC (11-digit format required) returns empty or error","Unknown county name or state combination returns no results","Drug not covered by any plan in the county returns plans_covering=0 with empty plans array","Invalid plan_year outside supported range returns error","RxCUI with no matching NDC on file returns null drug record","Rate limit exceeded beyond 3 free daily calls without payment returns 402 Payment Required"],"whenToPreferThis":"Use this endpoint when you need county-specific Medicare Part D formulary data including real cost-sharing details (copays, premiums, deductibles) for a specific drug across all available plans. It is ideal for benefits counseling agents, Medicare plan comparison tools, and patient cost-estimation workflows. It covers both PDP and Medicare Advantage drug plans for 2026 and 2027 plan years and is updated monthly from CMS formulary files — making it more current and structured than scraping Medicare Plan Finder.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-10-23T12:38:56.583Z","isFirstParty":false,"canonicalSlug":"medicare-part-d-drug-coverage-lookup-by-county-3f0c76d4"}