pbm_compensation_rollup

Pbm Compensation Rollup

What it answers

Sums Form 5500 Schedule C direct + indirect compensation for a named PBM across one or more plan years. Every aggregate runs SERVER-SIDE in SQL over the whole matching population; the per-provider-name and per-plan-year rows the total is made of ride the answer, and each alias spelling carries its own measured attribution. M-6 alias chain resolves OptumRx -> OPTUMRX + OPTUM RX + Catamaran (post-2015 acquisition), Express Scripts -> ESI / ESI MAIL PHARMACY, CVS Caremark -> all variants; a name that is NOT a registered alias_form says so instead of silently searching one literal string.

Reference demo (re-measured live 2026-08-01): OptumRx plan year 2023 -> $1,461,686,909 direct comp across 295 plan-filings and 295 provider rows, attributed OPTUMRX $1,036,556,258 / OPTUM RX $425,110,391 / Catamaran $20,260.

Inputs

pbm_name

string · required

acknowledge_era_break

boolean · optional

default: false

detail_limit

integer · optional

default: 25

year_max

integer · optional

default: 2024

year_min

integer · optional

default: 2009

Call it

From an agent: connect the Vlada MCP once (one click for Claude, ChatGPT, Cursor, VS Code) and ask in plain English; the agent selects pbm_compensation_rollup when the question fits. From code: the same tool over REST with an API key. The schema endpoint needs no key.

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

curl https://api.vladahealth.com/v1/tools/pbm_compensation_rollup/schema      # the JSON schema, no auth
# MCP endpoint (Streamable HTTP): https://mcp.vladahealth.com/mcp

What comes back

Typed rows plus provenance on every answer: the public source file, its vintage, the methodology, and a response_hash you can replay. Prove and replay tools turn any number into a re-runnable receipt. A number the data cannot support comes back as “not in the data”, never as zero.

Sources behind it

drug_silver.fact_form5500_service_provider
drug_silver.fact_form5500_filing

tables: drug_silver.fact_form5500_service_provider · drug_silver.fact_form5500_filing

Known limits

No gaps recorded for this tool. Absence of a recorded gap is not a claim of complete coverage; the answer itself says what it covers.

As of the 2026-09-19 build of the served surface · machine-readable catalog · the live server may run a different version; the schema endpoint above is authoritative for what is deployed.