Drugs and formularies

asp_pricing_lookup

ASP Pricing Lookup·v1.1.0·L2·read-only·MCP + REST·admitted 2026-09-19

Inputs

60 required

Sources

Known limits

Real answer

2.21scomplete

What it answers

1Given an HCPCS code or short-description search, returns Medicare Part B ASP quarterly payment-limit rows from drug_silver.fact_drug_asp_quarterly_v2 (is_current) with trend aggregates.
2Use for Part B reimbursement checks and CY 2026 IRA/MFP methodology caveats.

Inputs (6)

Name	Type	Required	Default
`acknowledge_era_break`	boolean	optional	false
`effective_period_end`	string	optional
`effective_period_start`	string	optional
`hcpcs_code`	string	optional
`release_quarter`	string	optional
`short_description`	string	optional

Call it

# MCP (https://mcp.vladahealth.com/mcp): the tool by name
asp_pricing_lookup(hcpcs_code="J0129")

curl -X POST https://api.vladahealth.com/v1/tools/asp_pricing_lookup \
  -H "Authorization: Bearer $VLADA_API_KEY" \
  -H "Content-Type: application/json" \
  -d '{"hcpcs_code":"J0129"}'

# the schema, no key
curl https://api.vladahealth.com/v1/tools/asp_pricing_lookup/schema

A real answer

customer seat, 2026-11-09·over REST·2.21s·status complete·first 6,000 of 37,921 chars·verbatim

{
 "value": {
  "headline": 45.937,
  "hcpcs_code_query": "J0129",
  "short_description_query": null,
  "effective_periods_covered": [
   "2007-01-01",
   "2007-04-01",
   "2007-07-01",
   "2007-10-01",
   "2008-01-01",
   "2008-04-01",
   "2008-07-01",
   "2008-10-01",
   "2009-01-01",
   "2009-04-01",
   "2009-07-01",
   "2009-10-01",
   "2010-01-01",
   "2010-04-01",
   "2010-07-01",
   "2010-10-01",
   "2011-01-01",
   "2011-04-01",
   "2011-07-01",
   "2011-10-01",
   "2012-01-01",
   "2012-04-01",
   "2012-07-01",
   "2012-10-01",
   "2013-01-01",
   "2013-04-01",
   "2013-07-01",
   "2013-10-01",
   "2014-01-01",
   "2014-04-01",
   "2014-07-01",
   "2014-10-01",
   "2015-01-01",
   "2015-04-01",
   "2015-07-01",
   "2015-10-01",
   "2016-01-01",
   "2016-04-01",
   "2016-07-01",
   "2016-10-01",
   "2017-01-01",
   "2017-04-01",
   "2017-07-01",
   "2017-10-01",
   "2018-01-01",
   "2018-04-01",
   "2018-07-01",
   "2018-10-01",
   "2019-01-01",
   "2019-04-01",
   "2019-07-01",
   "2019-10-01",
   "2020-01-01",
   "2020-04-01",
   "2020-07-01",
   "2020-10-01",
   "2021-01-01",
   "2021-04-01",
   "2021-07-01",
   "2021-10-01",
   "2022-01-01",
   "2022-04-01",
   "2022-07-01",
   "2022-10-01",
   "2023-01-01",
   "2023-04-01",
   "2023-07-01",
   "2023-10-01",
   "2024-01-01",
   "2024-04-01",
   "2024-07-01",
   "2024-10-01",
   "2025-01-01",
   "2025-04-01",
   "2025-07-01",
   "2025-10-01",
   "2026-01-01",
   "2026-04-01",
   "2026-07-01",
   "2026-10-01"
  ],
  "truncated": false,
  "aggregates": {
   "n_rows": 80,
   "n_distinct_hcpcs": 1,
   "min_payment_limit_usd": 18.688,
   "max_payment_limit_usd": 58.103,
   "mean_payment_limit_usd": 36.2652875,
   "median_payment_limit_usd": 42.730500000000006,
   "payment_limit_by_effective_period": {
    "2007-01-01": 18.698,
    "2007-04-01": 18.688,
    "2007-07-01": 18.688,
    "2007-10-01": 18.688,
    "2008-01-01": 18.688,
    "2008-04-01": 18.689,
    "2008-07-01": 18.689,
    "2008-10-01": 18.689,
    "2009-01-01": 19.141,
    "2009-04-01": 19.15,
    "2009-07-01": 19.148,
    "2009-10-01": 19.347,
    "2010-01-01": 19.521,
    "2010-04-01": 19.959,
    "2010-07-01": 19.828,
    "2010-10-01": 20.185,
    "2011-01-01": 20.43,
    "2011-04-01": 20.647,
    "2011-07-01": 20.916,
    "2011-10-01": 21.122,
    "2012-01-01": 21.389,
    "2012-04-01": 21.682,
    "2012-07-01": 21.934,
    "2012-10-01": 22.194,
    "2013-01-01": 22.398,
    "2013-04-01": 22.62,
    "2013-07-01": 22.841,
    "2013-10-01": 23.06,
    "2014-01-01": 23.427,
    "2014-04-01": 23.877,
    "2014-07-01": 32.214,
    "2014-10-01": 32.248,
    "2015-01-01": 33.154,
    "2015-04-01": 34.922,
    "2015-07-01": 35.814,
    "2015-10-01": 37.331,
    "2016-01-01": 39.442,
    "2016-04-01": 41.05,
    "2016-07-01": 41.981,
    "2016-10-01": 44.75,
    "2017-01-01": 45.88,
    "2017-04-01": 46.857,
    "2017-07-01": 47.613,
    "2017-10-01": 49.589,
    "2018-01-01": 48.549,
    "2018-04-01": 50.164,
    "2018-07-01": 51.628,
    "2018-10-01": 52.929,
    "2019-01-01": 51.614,
    "2019-04-01": 52.49,
    "2019-07-01": 53.944,
    "2019-10-01": 54.318,
    "2020-01-01": 54.849,
    "2020-04-01": 55.083,
    "2020-07-01": 56.739,
    "2020-10-01": 58.103,
    "2021-01-01": 56.867,
    "2021-04-01": 57.831,
    "2021-07-01": 45.323,
    "2021-10-01": 45.269,
    "2022-01-01": 44.522,
    "2022-04-01": 43.9,
    "2022-07-01": 44.22,
    "2022-10-01": 43.246,
    "2023-01-01": 43.498,
    "2023-04-01": 42.761,
    "2023-07-01": 43.271,
    "2023-10-01": 42.7,
    "2024-01-01": 43.163,
    "2024-04-01": 42.84,
    "2024-07-01": 43.727,
    "2024-10-01": 43.437,
    "2025-01-01": 43.797,
    "2025-04-01": 43.377,
    "2025-07-01": 44.494,
    "2025-10-01": 44.109,
    "2026-01-01": 44.769,
    "2026-04-01": 44.718,
    "2026-07-01": 45.859,
    "2026-10-01": 45.937
   }
  },
  "asp_rows": [
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q1 2007",
    "effective_period_start": "2007-01-01",
    "effective_period_end": "2007-03-31",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.698,
    "coinsurance_percentage": null,
    "notes": null,
    "vintage_tag": "asp_pre_2026_pre_mfp_layering"
   },
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q2 2007",
    "effective_period_start": "2007-04-01",
    "effective_period_end": "2007-06-30",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.688,
    "coinsurance_percentage": null,
    "notes": null,
    "vintage_tag": "asp_pre_2026_pre_mfp_layering"
   },
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q3 2007",
    "effective_period_start": "2007-07-01",
    "effective_period_end": "2007-09-30",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.688,
    "coinsurance_percentage": null,
    "notes": null,
    "vintage_tag": "asp_pre_2026_pre_mfp_layering"
   },
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q4 2007",
    "effective_period_start": "2007-10-01",
    "effective_period_end": "2007-12-31",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.688,
    "coinsurance_percentage": null,
    "notes": null,
    "vintage_tag": "asp_pre_2026_pre_mfp_layering"
   },
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q1 2008",
    "effective_period_start": "2008-01-01",
    "effective_period_end": "2008-03-31",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.688,
    "coinsurance_percentage": null,
    "notes": null,
    "vintage_tag": "asp_pre_2026_pre_mfp_layering"
   },
   {
    "hcpcs_code": "J0129",
    "release_quarter": "Q2 2008",
    "effective_period_start": "2008-04-01",
    "effective_period_end": "2008-06-30",
    "short_description": "Abatacept, inj",
    "hcpcs_dosage": "10 MG",
    "payment_limit_usd": 18.689,
    "coinsurance_pe
…

What comes back

Field	Holds
`status`	complete · partial · refused · failed · queued
`value`	rows or the figure, with its unit
`source · caveats · invariants_applied · response_hash`	the public file and vintage; what to know before citing; the rules honoured; replayable
`refusal`	code (15), message, recover_with

Sources

Kind	Name
source	drug_silver.fact_drug_asp_quarterly_v2
table	`drug_silver.fact_drug_asp_quarterly_v2`

Known limits (3)

1asp_cy_2026_mpfs_ira_mfp_layering
2asp_pricing_lookup_no_match
3asp_pricing_lookup_truncated

Admitted with a known defect
The reference call (J0129) took 31s and then returned 502 from the edge on the first machine walk (run 35516039355, 2026-09-20). 31s is INSIDE the 40s synchronous dispatch budget, so the door never timed out and has nothing to restate: the answer was built and the connection was dropped above it. The tool is not in ASYNC_HEAVY_TOOLS, so a caller who hits this has no background lane either. Owner: the serving lane (the bridge deadline / ALB idle timeout), not the door.

Admitted with a known defect

The reference call (J0129) took 31s and then returned 502 from the edge on the first machine walk (run 35516039355, 2026-09-20). 31s is INSIDE the 40s synchronous dispatch budget, so the door never timed out and has nothing to restate: the answer was built and the connection was dropped above it. The tool is not in ASYNC_HEAVY_TOOLS, so a caller who hits this has no background lane either. Owner: the serving lane (the bridge deadline / ALB idle timeout), not the door.

This page as markdown: /docs-md/tools/asp_pricing_lookup.md · every page in one file: /llms-full.txt