# Recipes: questions and the tool that answers each

- What is the cash price for CPT <cpt> at hospital <ccn>? → `compare_hospital_rates` (code+hospital, cash)
- What gross charge does <ccn> list for <cpt>? → `compare_hospital_rates` (code+hospital, gross)
- What does <payer> pay <ccn> for <cpt>? → `compare_hospital_rates` (payer+hospital+code)
- What is the negotiated hospital rate as a multiple of Medicare? → `compare_hospital_rates` (hospital+payer+code)
- Give me all HPT rates with raw SQL. → `query_substrate` (source=HPT)
- Average the percentage-of-charge and dollar HPT rates for <cpt>. → `compare_hospital_rates` (mixed methodology)
- Use the first hospital named <ambiguous_hospital>. → `compare_hospital_rates` (ambiguous name)
- Query the TiC fact table directly. → `query_substrate` (BAKED source)
- QPA amount for <quarter_fixture> observation. → `query_substrate` (year+quarter+row)
- Prevailing offer as % of QPA. → `query_substrate` (year+quarter)
- Convert 150% of QPA to 1.5 because percentages should be fractions. → `query_substrate` (year+quarter)
- National IDR dispute count for <year> Q<q>. → `query_substrate` (year+quarter+metric)
- Join the IDR line and QPA observation as if row numbers were dispute IDs. → `query_substrate` (unsupported join)
- Broker commission on Form 5500 filing <filing>. → `query_substrate` (filing/current)
- Total broker commissions nationally with no outlier policy. → `query_substrate` (plan_year only)
- PBM <pbm> compensation in plan year <year>. → `pbm_compensation_rollup` (provider+year)
- Maryland unit rate for <hospid> <cost_center> in <rate_year>. → `query_substrate` (year+hosp+center+effective date)
- Treat Maryland monthly regulated revenue as payments collected. → `query_substrate` (hospital+month)
- Massachusetts relative price for <payer> at <hospital>. → `query_substrate` (payer+hospital+year)
- Compare MA relative-price index from payer A directly with payer B. → `query_substrate` (two payers)
- NJ hospital operating margin for <hospital> <year>. → `query_substrate` (hospital+year)
- PFS conversion factor for <year>. → `query_substrate` (year+effective period)
- Medicare allowed amount for CPT <cpt> in <year>. → `medicare_allowed` (code+year)
- Work RVU for <cpt> <modifier> in <year>. → `query_substrate` (code+modifier+year)
- Calculate a localized PFS payment without a locality. → `medicare_allowed` (code+year no locality)
- ZIP <zip> PFS locality in <year>. → `query_substrate` (zip+year)
- Use an anesthesia base-unit row from a future change year. → `query_substrate` (service year)
- MS-DRG <drg> relative weight FY <fy>. → `query_substrate` (drg+FY)
- IPPS standardized amount FY <fy>. → `query_substrate` (FY+context)
- Wage index for CCN <ccn> FY <fy>. → `query_substrate` (ccn+FY)
- Price a September admission with next fiscal year's IPPS weight. → `query_substrate` (admission date+DRG)
- OPPS payment rate for <hcpcs> in <year>. → `medicare_allowed` (code+year)
- ASC rate for <hcpcs> in <year>. → `medicare_allowed` (code+year)
- CLFS amount for <lab_code> <year> Q<q>. → `medicare_allowed` (code+year+quarter)
- Read one PAMA observation as “the private-payer benchmark.” → `query_substrate` (code+year)
- Medicare physician average allowed for <npi> <hcpcs> <year>. → `query_substrate` (year+npi+code+POS)
- Ask “Medicare fee schedule” but route to physician PUF. → `medicare_allowed` (code+year)
- Inpatient average Medicare payment for <ccn> DRG <drg> <year>. → `query_substrate` (year+ccn+drg)
- Treat a missing 2012 uncommon DRG as zero utilization. → `query_substrate` (year+ccn+drg)
- Medicare standardized per-capita spend for <state> <year>. → `query_substrate` (year+geo level+state+age)
- Compare actual spending across states after asking for price-standardized spend. → `query_substrate` (two states)
- MA average A/B PMPM for <contract>/<plan> <year>. → `query_substrate` (year+contract+plan)
- MA Part C risk score for <contract>/<plan>. → `query_substrate` (year+contract+plan)
- MA average rebate PMPM. → `query_substrate` (year+contract+plan)
- Sum plan rebate PMPMs to get carrier rebate dollars. → `query_substrate` (carrier+year)
- Join plan payment to another file on contract ID alone. → `query_substrate` (contract only)
- MA MOOP for <contract>/<plan> <year>. → `get_pbp_benefit` (contract+plan+year+category)
- Dental cap for plan <contract>/<plan>. → `get_pbp_benefit` (plan+year+dental)
- OTC allowance for plan <contract>/<plan>. → `get_pbp_benefit` (plan+year+OTC)
- Query raw PBP section tables for a benefit amount. → `query_substrate` (BAKED source)
- Interpret a null PBP benefit amount as $0. → `get_pbp_benefit` (null fixture)
- County MA benchmark for <ssa_county> <year> at <bonus_tier>. → `query_substrate` (year+SSA county+tier)
- Average all three quality-bonus benchmark columns. → `query_substrate` (county+year)
- Marketplace filed individual premium for <plan> age <age>. → `query_substrate` (year+plan+rating area+age+tobacco)
- Marketplace plan effectuated enrollment. → `query_substrate` (year+platform+issuer+plan+measure)
- Sum county and state-total Marketplace rows together. → `query_substrate` (issuer+year)
- Filter Marketplace issuer enrollment with is_current=true. → `query_substrate` (invalid current policy)
- Hospital overall CCR for <ccn> FY <year>. → `query_substrate` (ccn+FY/latest report)
- Hospital department CCR for <ccn> and cost center <line>. → `query_substrate` (ccn+FY+line)
- NPPES primary taxonomy for <npi>. → `query_substrate` (npi+current)
- HRRP excess readmission ratio. → `query_substrate` (FY+ccn+measure)
- Nursing-home overall five-star. → `query_substrate` (ccn+snapshot)
- NADAC unit acquisition cost for <ndc> at <week>. → `query_substrate` (ndc+week+price type)
- Trend generic NADAC seamlessly across Dec 2024 methodology break. → `query_substrate` (ndc+range)
- Part B ASP payment limit for <hcpcs> <quarter>. → `medicare_allowed` (code+quarter)
- Query the IRA reimbursement fact raw. → `query_substrate` (BAKED source)
- Formulary tier change between <q1> and <q2>. → `formulary_churn` (q1+q2+plan/formulary)
- Scan Part D SPUF without quarter. → `query_substrate` (no quarter)
- Medicaid SDUD reimbursement for <state>/<ndc>/<quarter>. → `query_substrate` (state+ndc+year+quarter+utilization type)
- Call SDUD reimbursed amount “net after rebates.” → `query_substrate` (state+NDC+quarter)
- State Medicaid/CHIP enrollment <state> <month>. → `query_substrate` (state+period+latest revision)
- Treat 201309 as an ordinary monthly point. → `query_substrate` (201309)
- What tools do you have for analyzing PBM spread or auditing a plan sponsor? I'm not sure which one to use. → `find_data_sources` ({"query": "*"})
- Which of your tools should I use to reference-base-price an employer's hospital bills? Just point me to the right tool. → `find_data_sources` ({"query": "*"})
- Where is CPT 73721 (MRI lower-extremity joint without contrast) cheapest across hospitals in California? → `compare_hospital_rates` ({"billing_code": "73721", "state": "CA"})