Lactulose

• CMS NADAC (pharmacy acquisition, weekly)
• CMS Part B ASP quarterly payment limits
• CMS Maximum Fair Prices (IRA negotiated, NDC-level)
• Medicare Part D Spending by Drug (data.cms.gov, name-matched)
• VA FSS / Big4 federal contract prices (va.gov, twice monthly)
• ACA Federal Upper Limits + weighted AMP (data.medicaid.gov, monthly)
• California SB-17 WAC filings (list price, per package)

Each rung is the newest figure for this NDC from one federal price system, shown with its own unit. Part D is matched by drug name because CMS publishes no NDCs there; it is gross spending, before confidential rebates.

Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.

• CMS quarterly Prescription Drug Plan Formulary & Pricing files (SPUF)

Negotiated 30-day point-of-sale unit prices and formulary terms aggregated across every unsuppressed Part D and MA-PD plan for the quarter shown. Point of sale means gross of confidential rebates. CMS publishes one representative NDC per drug concept (RxCUI) rather than every package, so these figures come from CMS's representative package for the same drug — matched on generic name, strength, and dosage form. Estimated from MedPAC's program-wide rebate aggregates (June 2023: DIR = 29% of gross Part D spending; brand rebates ≈ 25–40% of gross, generics minimal). Actual rebates are confidential and vary widely by drug — this is a range, not a fact about this drug.

Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.