pbm_compensation_rollup

What it answers

1. 1Sums Form 5500 Schedule C direct + indirect compensation for a named PBM across one or more plan years.
2. 2Every 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.
3. 3M-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.
4. 4Reference 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 (5)

Call it

# MCP (https://mcp.vladahealth.com/mcp): the tool by name
pbm_compensation_rollup(pbm_name="OptumRx", year_min=2023, year_max=2023, detail_limit=5)

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":"OptumRx","year_min":2023,"year_max":2023,"detail_limit":5}'

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

A real answer

{
 "value": {
  "headline": 1461686909.0,
  "pbm_name_query": "OptumRx",
  "canonical_pbm_name": "OptumRx",
  "alias_resolution_applied": true,
  "year_min": 2023,
  "year_max": 2023,
  "status": "ok",
  "total_direct_comp_usd": 1461686909.0,
  "total_indirect_comp_usd": 4164066.0,
  "provider_row_count": 295,
  "distinct_filings": 295,
  "distinct_eins": 9,
  "distinct_provider_names": 15,
  "outlier_rows_over_threshold": 3,
  "max_single_direct_comp_usd": 221743869.0,
  "null_indirect_rows": 58,
  "aliases_searched": [
   "Catamaran",
   "OPTUM RX",
   "OPTUMRX",
   "OptumRx"
  ],
  "alias_attribution": [
   {
    "alias_form": "CATAMARAN",
    "spellings": [
     "Catamaran"
    ],
    "provider_rows": 1,
    "distinct_filings": 1,
    "direct_comp_usd": 20260.0
   },
   {
    "alias_form": "OPTUM RX",
    "spellings": [
     "OPTUM RX"
    ],
    "provider_rows": 143,
    "distinct_filings": 143,
    "direct_comp_usd": 425110391.0
   },
   {
    "alias_form": "OPTUMRX",
    "spellings": [
     "OPTUMRX",
     "OptumRx"
    ],
    "provider_rows": 152,
    "distinct_filings": 152,
    "direct_comp_usd": 1036576518.0
   }
  ],
  "provider_name_lines": [
   {
    "provider_name": "OPTUMRX, INC.",
    "provider_rows": 75,
    "distinct_filings": 75,
    "direct_comp_usd": 481597723.0,
    "indirect_comp_usd": 883910.0
   },
   {
    "provider_name": "OPTUMRX, INC",
    "provider_rows": 29,
    "distinct_filings": 29,
    "direct_comp_usd": 301831683.0,
    "indirect_comp_usd": 475817.0
   },
   {
    "provider_name": "OPTUM RX INC.",
    "provider_rows": 53,
    "distinct_filings": 53,
    "direct_comp_usd": 279592482.0,
    "indirect_comp_usd": 1099991.0
   },
   {
    "provider_name": "OPTUMRX INC.",
    "provider_rows": 3,
    "distinct_filings": 3,
    "direct_comp_usd": 170838236.0,
    "indirect_comp_usd": 616582.0
   },
   {
    "provider_name": "OPTUM RX INC",
    "provider_rows": 12,
    "distinct_filings": 12,
    "direct_comp_usd": 77160212.0,
    "indirect_comp_usd": 178499.0
   }
  ],
  "plan_year_lines": [
   {
    "plan_year": 2023,
    "provider_rows": 295,
    "distinct_filings": 295,
    "direct_comp_usd": 1461686909.0,
    "indirect_comp_usd": 4164066.0
   }
  ],
  "detail_rows_returned": 5,
  "detail_rows_total": 15,
  "sql_executed": []
 },
 "unit": "USD",
 "result_status": "answered",
 "methodology_era": {
  "era_name": "form5500_post_2009_full_disclosure",
  "era_start": "2023-01-01",
  "era_end": "2023-12-31"
 },
 "methodology_blend_factors": null,
 "source": {
  "source_url": "medicare://pbm_compensation_rollup"
 },
 "vintage": "as_restated",
 "cms_vintage_sequence": 1,
 "parse_revision": 1,
 "as_of_observed": null,
 "as_of_asserted": null,
 "as_of_effective": null,
 "caveats": [],
 "confidence": 1.0,
 "confidence_basis": "tool_measured",
 "finality_confidence": null,
 "response_hash": "fba0b055845f7ccc5e0f5d2553c69a8c2804e5cd5decfaa19f6ba2b31d096729",
 "semantic_version": 2,
 "tool_version": "2.0.0",
 "parser_artifact_hash": "0b11193fb97519397f53ffe2917938b1bf95f408fccb5bae6d356b17ef22a148",
 "parser_artifact_hash_basis": "tool_source_sha256",
 "signature": null,
 "tenant_id": "probe-customer-canary",
 "status": "complete",
 "audit_id": "0299c514-5166-40d4-af91-08ff9c58e4c3",
 "timestamp": "2026-11-09T21:38:15.134342Z",
 "request_id": "0b332e1d-3b41-4611-8a6d-9cb6391618c6",
 "audience": "customer",
 "answer": {
  "value": 1461686909.0,
  "value_ref": "value",
  "unit": "USD",
  "scope": {
   "tool": "pbm_compensation_rollup",
   "filters": {
    "pbm_name": "OptumRx",
    "year_min": 2023,
    "year_max": 2023,
    "detail_limit": 5
   }
  }
 },
 "method": "Read from the CMS publication. The published values are reported as published, with no adjustment or modelling applied.",
 "evidence": {
  "response_hash": "fba0b055845f7ccc5e0f5d2553c69a8c2804e5cd5decfaa19f6ba2b31d096729",
  "audit_id": "0299c514-5166-40d4-af91-08ff9c58e4c3",
  "request_id": "0b332e1d-3b41-4611-8a6d-9cb6391618c6"
 }
}

What comes back

Sources

Known limits (0)