- REMINDER: PCP names are not required on member ID cards for any line of business. Members should not be turned away if a PCP name is not listed. Please access CareFirst Direct to verify eligibility and benefits.
- The Provider Updates and Attestation tool will be available for use starting April 6th.
Machine Readable Data
Machine Readable Data for Provider Network and Prescription Formulary Content for Federally-Facilitated Marketplace (FFM) Qualified Health Plans (QHP)
As required by the Patient Protection and Affordable Care Act, for plan years beginning on or after January 1, 2016, qualified health plan (QHP) issuers in the Federally-Facilitated Marketplace (FFM) are required to publish information regarding their provider directories and formulary drug lists on their website in a machine-readable format.
This requirement increases and enhances consumer transparency by allowing software developers to access up-to-date, accurate and complete formulary and provider data needed to create innovative and informative tools.
In accordance with this requirement, the following files are available for use:
- Index data
- Plan data
- Medical provider data - file 1
- Medical provider data - file 2
- Medical provider data - file 3
- Medical provider data - file 4
- Medical provider data - file 5
- Medical provider data - file 6
- Medical provider data - file 7
- Medical provider data - file 8
- Dental provider data - file 1
- Dental provider data - file 2
- Dental provider data - file 3
- Dental provider data - file 4
- Dental provider data - file 5
- Prescription formulary data - file 1
- Prescription formulary data - file 2