--- type: "firecrawl-provider" description: "Medicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution." use_when: "Medicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution.\n\nMedicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution." categories: "Life sciences" capabilities: 3 credits_per_call: 5 --- # CMS Medicare Drug Prices: Negotiated Prices and Part B ASP Payment Limits on Firecrawl Alexandria Medicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution. - Categories: Life sciences - Category index: [Life sciences category](https://firecrawl.dev/alexandria/agents/categories/life-sciences) - Provider key: `cms-gov` - Access: Firecrawl credits - Cost: 5 credits per call ## More - [Human guide](https://firecrawl.dev/app/alexandria/cms-gov) - [OpenAPI spec](https://firecrawl.dev/alexandria/agents/providers/cms-gov/openapi.json) ## Capabilities - [Search](https://firecrawl.dev/alexandria/agents/providers/cms-gov/negotiated-prices/search): Medicare's negotiated prices (maximum fair prices, MFPs) for the drugs CMS selected under the Inflation Reduction Act's Medicare Drug Price Negotiation Program, filtered by brand name or active ingredient, NDC or initial price applicability year; no filter lists every selected drug. Each drug has its brand names, active ingredient, initial price applicability year, a status (price in effect, agreed, pending or ended), the MFP per 30-day equivalent supply for each period including inflation adjustments, Part B HCPCS codes, CMS's deselection determination and MFP explanation file, and its NDC-11s with the per-unit MFP of each period, update type and remarks. No match is an empty result. - [Payment limit history](https://firecrawl.dev/alexandria/agents/providers/cms-gov/asp-pricing/payment_limit_history): One HCPCS Level II code's Medicare Part B payment allowance limit in every quarterly CMS ASP pricing file the ASP Pricing Files page links (from 2021-Q1), or in a `from`-`to` range, oldest first. Each quarter has its effective dates, the ASP data quarter it rests on, the billing unit, the payment limit in USD per billing unit, the coinsurance percentage, vaccine and blood limits, CMS's notes and the file it came from. Quarters whose file lacks the code are listed apart. A code in none of the files read is `not_found`. - [Payment limits](https://firecrawl.dev/alexandria/agents/providers/cms-gov/asp-pricing/payment_limits): Medicare Part B payment allowance limits for drugs, per HCPCS Level II code, from CMS's quarterly ASP pricing file, joined to the ASP NDC-HCPCS crosswalk. Filter by brand or generic name, HCPCS code or NDC, for the newest quarter or any quarter CMS links from 2021-Q1; no filter pages through every code. Each code has its short description, billing unit (dosage), payment limit in USD per billing unit, beneficiary coinsurance percentage, the vaccine and blood AWP-based limits where they apply, CMS's notes, and its NDCs with drug name, labeler, package size and billable units. CPT-coded rows (AMA copyright) are left out. No match is an empty result. ## 1. Choose this provider when Medicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution. Medicare drug prices from two CMS sources. First, the drugs CMS selected for Medicare drug price negotiation under the Inflation Reduction Act and their negotiated prices, which the statute calls maximum fair prices (MFPs), from CMS's Selected Drug List and Negotiated Prices file: the 10 drugs with prices from 2026 (Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, NovoLog/Fiasp), the 15 from 2027 (among them Ozempic, Rybelsus and Wegovy) and the 15 selected for 2028, each with its MFP per 30-day equivalent supply by period, status, Part B HCPCS codes, deselection and every NDC-11 with its per-unit MFP. Second, Medicare Part B payment allowance limits for physician-administered drugs (generally 106% of the manufacturer-reported average sales price, ASP) per HCPCS Level II code from CMS's quarterly ASP pricing files since 2021, for example Keytruda (J9271) or Opdivo (J9299), joined to the ASP NDC-HCPCS crosswalk for each code's NDCs, labelers and billable units per package, plus one code's limit across every quarter. CPT-coded rows (AMA copyright) are left out. Public domain U.S. Government data; every result carries CMS's attribution. ## 2. Minimal request Call `POST https://api.firecrawl.dev/v2/scrape` with `{ alexandria: { provider, capability, options } }`. For a batch, send `{ alexandria: [...] }` with up to 10 calls. ```json { "provider": "cms-gov", "capability": "negotiated-prices/search", "options": { "drug": "eliquis" } } ``` ## 3. Add provider options Use only the options needed for the task: - `drug` (string): Brand name or active ingredient, matched case-insensitively anywhere in the selected drug's name (which lists its brands) or active ingredient: `eliquis`, `Wegovy`, `semaglutide`, `insulin aspart`. Example: `` - `include_ndcs` (boolean): List each NDC-11 with its per-unit prices. Defaults to true when `drug` or `ndc` is given, false otherwise, so a list of selected drugs stays compact; `ndc_count` is always given. With `ndc`, only the matching NDCs are listed. Example: `false` - `ipay` (number): Initial price applicability year, the first year a drug's negotiated price applies: 2026 (10 drugs), 2027 (15), 2028 (15, selected January 2026). Example: `2026` - `limit` (number): Most drugs to return; `total_count` counts every match. Example: `50` - `ndc` (string): An NDC-11 as 11 digits (`00169413013`) or hyphenated 5-4-2 (`00169-4130-13`), a hyphenated 10-digit NDC (`0169-4130-13`, 4-4-2, 5-3-2 or 5-4-1), or an NDC-9 product code (`00169-4130`, `001694130`). A bare 10-digit NDC is ambiguous and rejected. Matches the NDC-11, CMS's cross-referenced NDC-11 or the NDC-9. Example: `00169413013` ## 4. Request through your preferred interface ### JavaScript ```javascript const result = await firecrawl.scrape({ alexandria: { provider: "cms-gov", capability: "negotiated-prices/search", options: { drug: "eliquis", }, }, }); ``` ### Python ```python result = firecrawl.scrape_alexandria({ "provider": "cms-gov", "capability": "negotiated-prices/search", "options": { "drug": "eliquis" } }) ``` ### cURL ```sh curl https://api.firecrawl.dev/v2/scrape \ -H "Authorization: Bearer $FIRECRAWL_API_KEY" \ -H "Content-Type: application/json" \ -d '{ "alexandria": { "provider": "cms-gov", "capability": "negotiated-prices/search", "options": { "drug": "eliquis" } } }' ``` ### CLI ```sh firecrawl scrape 'cms-gov/negotiated-prices/search' \ --options '{"drug":"eliquis"}' ``` ### MCP Call the FCX MCP retrieve tool with this object: ```json { "provider": "cms-gov", "capability": "negotiated-prices/search", "options": { "drug": "eliquis" } } ``` Ask for only the returned fields needed by the task. ## 5. Full request shape ```json { "provider": "cms-gov", "capability": "negotiated-prices/search", "options": { "drug": "eliquis" } } ``` ## 6. Response data The response includes `success`, `provider`, `capability`, `creditsCost` and `data`. This example shows the provider payload in `data`: ```json { "file_name": "CMS_Negotiation_Program_Selected_Drug_List_and_Maximum_Fair_Price_Data_File_20260921.csv", "file_url": "https://www.cms.gov/files/zip/selected-drug-list-negotiated-prices-also-known-maximum-fair-prices-statutezip.zip", "license": { "attribution": "Source: Centers for Medicare & Medicaid Services (CMS), Medicare Drug Price Negotiation Program Selected Drug List and Negotiated Prices (Maximum Fair Prices). Use does not imply CMS endorsement.", "name": "Public domain (U.S. Government work)", "url": "https://www.cms.gov/about-cms/web-policies-important-links/about-website/link-to-us" }, "results": [ { "active_ingredient": "APIXABAN", "brand_names": [ "ELIQUIS", "ELIQUIS SPRINKLE" ], "deselection": null, "hcpcs_codes": [], "initial_price_applicability_year": 2026, "mfp_explanation_url": "https://www.cms.gov/files/zip/mfp-explanation-eliquis.zip", "mfp_per_30_day_supply": [ { "effective_date": "2026-01-01", "end_date": "2026-12-31", "price": 231 }, { "effective_date": "2027-01-01", "end_date": null, "price": 237.25 } ], "ndc_count": 12, "ndcs": [ { "hcpcs_code": null, "ndc": "00003089321", "ndc_5_4_2": "00003-0893-21", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089331", "ndc_5_4_2": "00003-0893-31", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089341", "ndc_5_4_2": "00003-0893-41", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089421", "ndc_5_4_2": "00003-0894-21", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089431", "ndc_5_4_2": "00003-0894-31", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089441", "ndc_5_4_2": "00003-0894-41", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089470", "ndc_5_4_2": "00003-0894-70", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089828", "ndc_5_4_2": "00003-0898-28", "ndc_9": "00003-0898", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 3.85, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 3.954139, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102812", "ndc_5_4_2": "00003-1028-12", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102828", "ndc_5_4_2": "00003-1028-28", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102884", "ndc_5_4_2": "00003-1028-84", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003376474", "ndc_5_4_2": "00003-3764-74", "ndc_9": "00003-3764", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null } ], "selected_drug_name": "ELIQUIS; ELIQUIS SPRINKLE", "source_url": "https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices", "status": "price_in_effect", "status_label": "Negotiated price in effect since 2026-01-01" } ], "source_updated_at": "2026-09-21", "source_url": "https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices", "total_count": 1 } ``` ## API reference-derived contract The following capability contract is generated from the same normalized Alexandria API reference exposed in the API spec. ### Search - Capability: `negotiated-prices/search` - Description: Medicare's negotiated prices (maximum fair prices, MFPs) for the drugs CMS selected under the Inflation Reduction Act's Medicare Drug Price Negotiation Program, filtered by brand name or active ingredient, NDC or initial price applicability year; no filter lists every selected drug. Each drug has its brand names, active ingredient, initial price applicability year, a status (price in effect, agreed, pending or ended), the MFP per 30-day equivalent supply for each period including inflation adjustments, Part B HCPCS codes, CMS's deselection determination and MFP explanation file, and its NDC-11s with the per-unit MFP of each period, update type and remarks. No match is an empty result. - Instructions: For "what is Medicare's negotiated price for Eliquis in 2026 and 2027", "which drugs were selected for 2028", "does NDC 00169-4130-13 have a maximum fair price" or "which negotiated drugs were deselected". These are Medicare negotiated prices only: for what Medicare Part B pays per HCPCS code each quarter (ASP payment limits), use asp-pricing/payment_limits; for what pharmacies pay, use data-medicaid-gov prices/search (NADAC); for Medicare and Medicaid spending on a drug, use data-cms-gov drug-spending/search. - Cost: 5 credits per call - Capability file: [Search](https://firecrawl.dev/alexandria/agents/providers/cms-gov/negotiated-prices/search) Accepted options: - `drug` (string): Brand name or active ingredient, matched case-insensitively anywhere in the selected drug's name (which lists its brands) or active ingredient: `eliquis`, `Wegovy`, `semaglutide`, `insulin aspart`. Example: `` - `include_ndcs` (boolean): List each NDC-11 with its per-unit prices. Defaults to true when `drug` or `ndc` is given, false otherwise, so a list of selected drugs stays compact; `ndc_count` is always given. With `ndc`, only the matching NDCs are listed. Example: `false` - `ipay` (number): Initial price applicability year, the first year a drug's negotiated price applies: 2026 (10 drugs), 2027 (15), 2028 (15, selected January 2026). Example: `2026` - `limit` (number): Most drugs to return; `total_count` counts every match. Example: `50` - `ndc` (string): An NDC-11 as 11 digits (`00169413013`) or hyphenated 5-4-2 (`00169-4130-13`), a hyphenated 10-digit NDC (`0169-4130-13`, 4-4-2, 5-3-2 or 5-4-1), or an NDC-9 product code (`00169-4130`, `001694130`). A bare 10-digit NDC is ambiguous and rejected. Matches the NDC-11, CMS's cross-referenced NDC-11 or the NDC-9. Example: `00169413013` Response schema example: ```json { "file_name": "CMS_Negotiation_Program_Selected_Drug_List_and_Maximum_Fair_Price_Data_File_20260921.csv", "file_url": "https://www.cms.gov/files/zip/selected-drug-list-negotiated-prices-also-known-maximum-fair-prices-statutezip.zip", "license": { "attribution": "Source: Centers for Medicare & Medicaid Services (CMS), Medicare Drug Price Negotiation Program Selected Drug List and Negotiated Prices (Maximum Fair Prices). Use does not imply CMS endorsement.", "name": "Public domain (U.S. Government work)", "url": "https://www.cms.gov/about-cms/web-policies-important-links/about-website/link-to-us" }, "results": [ { "active_ingredient": "APIXABAN", "brand_names": [ "ELIQUIS", "ELIQUIS SPRINKLE" ], "deselection": null, "hcpcs_codes": [], "initial_price_applicability_year": 2026, "mfp_explanation_url": "https://www.cms.gov/files/zip/mfp-explanation-eliquis.zip", "mfp_per_30_day_supply": [ { "effective_date": "2026-01-01", "end_date": "2026-12-31", "price": 231 }, { "effective_date": "2027-01-01", "end_date": null, "price": 237.25 } ], "ndc_count": 12, "ndcs": [ { "hcpcs_code": null, "ndc": "00003089321", "ndc_5_4_2": "00003-0893-21", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089331", "ndc_5_4_2": "00003-0893-31", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089341", "ndc_5_4_2": "00003-0893-41", "ndc_9": "00003-0893", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089421", "ndc_5_4_2": "00003-0894-21", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089431", "ndc_5_4_2": "00003-0894-31", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089441", "ndc_5_4_2": "00003-0894-41", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089470", "ndc_5_4_2": "00003-0894-70", "ndc_9": "00003-0894", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003089828", "ndc_5_4_2": "00003-0898-28", "ndc_9": "00003-0898", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 3.85, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 3.954139, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102812", "ndc_5_4_2": "00003-1028-12", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102828", "ndc_5_4_2": "00003-1028-28", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003102884", "ndc_5_4_2": "00003-1028-84", "ndc_9": "00003-1028", "prices": [ { "as_of_date": "2025-12-22", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 0.48125, "remarks": "New NDC added after IPAY 2026 announcement", "update_type": "New NDC" }, { "as_of_date": "2025-12-22", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 0.494267, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null }, { "hcpcs_code": null, "ndc": "00003376474", "ndc_5_4_2": "00003-3764-74", "ndc_9": "00003-3764", "prices": [ { "as_of_date": "2024-08-15", "effective_date": "2026-01-01", "end_date": "2026-12-31", "hcpcs_dosage_price": null, "mfp_per_unit": 4.145072, "remarks": "Added for IPAY 2026 announcement. End dated to reflect inflation adjustment", "update_type": "End Date" }, { "as_of_date": "2025-11-25", "effective_date": "2027-01-01", "end_date": null, "hcpcs_dosage_price": null, "mfp_per_unit": 4.257193, "remarks": "Inflation adjustment for IPAY 2026 NDC", "update_type": "Inflation" } ], "xref_ndc": null } ], "selected_drug_name": "ELIQUIS; ELIQUIS SPRINKLE", "source_url": "https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices", "status": "price_in_effect", "status_label": "Negotiated price in effect since 2026-01-01" } ], "source_updated_at": "2026-09-21", "source_url": "https://www.cms.gov/initiatives/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program/selected-drugs-negotiated-prices", "total_count": 1 } ``` ### Payment limit history - Capability: `asp-pricing/payment_limit_history` - Description: One HCPCS Level II code's Medicare Part B payment allowance limit in every quarterly CMS ASP pricing file the ASP Pricing Files page links (from 2021-Q1), or in a `from`-`to` range, oldest first. Each quarter has its effective dates, the ASP data quarter it rests on, the billing unit, the payment limit in USD per billing unit, the coinsurance percentage, vaccine and blood limits, CMS's notes and the file it came from. Quarters whose file lacks the code are listed apart. A code in none of the files read is `not_found`. - Instructions: For "how has Medicare's Part B payment limit for Keytruda (J9271) changed since 2021", "track a biosimilar's payment limit quarter by quarter" or "when did J9299 first get a payment limit". Find a drug's HCPCS code first with asp-pricing/payment_limits. Each call reads up to one file per quarter (24 since 2021), so pass `from` when only recent quarters matter. - Cost: 5 credits per call - Capability file: [Payment limit history](https://firecrawl.dev/alexandria/agents/providers/cms-gov/asp-pricing/payment_limit_history) Accepted options: - `from` (string): First quarter to read, `2024-Q1`; defaults to the oldest CMS links. Pattern: ^[0-9]{4}-[Qq][1-4]$. Example: `2024-Q1` - `hcpcs` (string, required): A HCPCS Level II code, a letter and four digits: `J9271`. CPT codes (five digits) are AMA copyright and not served. Example: `J9271` - `to` (string): Last quarter to read; defaults to the newest. Pattern: ^[0-9]{4}-[Qq][1-4]$. Example: `` Response schema example: ```json { "dosage": "1 MG", "hcpcs_code": "J9271", "license": { "attribution": "Source: Centers for Medicare & Medicaid Services (CMS), Medicare Part B Drug Average Sales Price (ASP) payment allowance limits and ASP NDC-HCPCS crosswalk. CPT codes are omitted. Use does not imply CMS endorsement.", "name": "Public domain (U.S. Government work)", "url": "https://www.cms.gov/about-cms/web-policies-important-links/about-website/link-to-us" }, "quarters": [ { "asp_data_quarter": "2020-Q3", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2021-01-01", "effective_to": "2021-03-31", "file_name": "section 508 version of January 2021 ASP Pricing File updated 112321.csv", "file_url": "https://www.cms.gov/files/zip/january-2021-asp-pricing-file.zip", "notes": null, "payment_limit": 50.648, "quarter": "2021-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2020-Q4", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2021-04-01", "effective_to": "2021-06-30", "file_name": "section 508 version of April 2021 ASP Pricing File updated 030122.csv", "file_url": "https://www.cms.gov/files/zip/april-2021-asp-pricing-file.zip", "notes": null, "payment_limit": 51.616, "quarter": "2021-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2021-Q1", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2021-07-01", "effective_to": "2021-09-30", "file_name": "section 508 version of July 2021 ASP Pricing File updated 060222.csv", "file_url": "https://www.cms.gov/files/zip/july-2021-asp-pricing-file.zip", "notes": null, "payment_limit": 51.349, "quarter": "2021-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2021-Q2", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2021-10-01", "effective_to": "2021-12-31", "file_name": "section 508 version of October 2021 ASP Pricing File updated 060222.csv", "file_url": "https://www.cms.gov/files/zip/october-2021-asp-pricing-file.zip", "notes": null, "payment_limit": 52.754, "quarter": "2021-Q4", "vaccine_limit": null }, { "asp_data_quarter": "2021-Q3", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2022-01-01", "effective_to": "2022-03-31", "file_name": "section 508 version of January 2022 ASP Pricing File updated 060222.csv", "file_url": "https://www.cms.gov/files/zip/january-2022-asp-pricing-file.zip", "notes": null, "payment_limit": 52.3, "quarter": "2022-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2021-Q4", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2022-04-01", "effective_to": "2022-06-30", "file_name": "section 508 version of April 2022 ASP Pricing File updated 120222.csv", "file_url": "https://www.cms.gov/files/zip/april-2022-asp-pricing-file.zip", "notes": null, "payment_limit": 53.699, "quarter": "2022-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2022-Q1", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2022-07-01", "effective_to": "2022-09-30", "file_name": "section 508 version of July 2022 ASP Pricing File updated 060223.csv", "file_url": "https://www.cms.gov/files/zip/july-2022-asp-pricing-file.zip", "notes": null, "payment_limit": 53.139, "quarter": "2022-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2022-Q2", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2022-10-01", "effective_to": "2022-12-31", "file_name": "section 508 version of October 2022 ASP Pricing File updated 062223xls.csv", "file_url": "https://www.cms.gov/files/zip/october-2022-asp-pricing-file.zip", "notes": null, "payment_limit": 54.548, "quarter": "2022-Q4", "vaccine_limit": null }, { "asp_data_quarter": "2022-Q3", "blood_limit": null, "coinsurance_percentage": null, "dosage": "1 MG", "effective_from": "2023-01-01", "effective_to": "2023-03-31", "file_name": "section 508 version of January 2023 ASP Pricing File updated 120623.csv", "file_url": "https://www.cms.gov/files/zip/january-2023-asp-pricing-file.zip", "notes": null, "payment_limit": 53.914, "quarter": "2023-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2022-Q4", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2023-04-01", "effective_to": "2023-06-30", "file_name": "section 508 version of April 2023 ASP Pricing File updated 022324.csv", "file_url": "https://www.cms.gov/files/zip/april-2023-asp-pricing-file.zip", "notes": null, "payment_limit": 55.417, "quarter": "2023-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2023-Q1", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2023-07-01", "effective_to": "2023-09-30", "file_name": "section 508 version of July 2023 ASP Pricing File updated 060524.csv", "file_url": "https://www.cms.gov/files/zip/july-2023-asp-pricing-file.zip", "notes": null, "payment_limit": 54.811, "quarter": "2023-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2023-Q2", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2023-10-01", "effective_to": "2023-12-31", "file_name": "section 508 version of October 2023 ASP Pricing File updated 101024.csv", "file_url": "https://www.cms.gov/files/zip/october-2023-asp-pricing-file.zip", "notes": null, "payment_limit": 56.412, "quarter": "2023-Q4", "vaccine_limit": null }, { "asp_data_quarter": "2023-Q3", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2024-01-01", "effective_to": "2024-03-31", "file_name": "section 508 version of January 2024 ASP Pricing File updated 120524.csv", "file_url": "https://www.cms.gov/files/zip/january-2024-asp-pricing-file.zip", "notes": null, "payment_limit": 55.73, "quarter": "2024-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2023-Q4", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2024-04-01", "effective_to": "2024-06-30", "file_name": "section 508 version of April 2024 ASP Pricing File updated 030725.csv", "file_url": "https://www.cms.gov/files/zip/april-2024-asp-pricing-file.zip", "notes": null, "payment_limit": 57.307, "quarter": "2024-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2024-Q1", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2024-07-01", "effective_to": "2024-09-30", "file_name": "section 508 version of Jul 2024 ASP Pricing File updated 052725.csv", "file_url": "https://www.cms.gov/files/zip/july-2024-asp-pricing-file.zip", "notes": null, "payment_limit": 56.658, "quarter": "2024-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2024-Q2", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2024-10-01", "effective_to": "2024-12-31", "file_name": "section 508 version of Oct 2024 ASP Pricing File updated 052725.csv", "file_url": "https://www.cms.gov/files/zip/october-2024-asp-pricing-file.zip", "notes": null, "payment_limit": 58.216, "quarter": "2024-Q4", "vaccine_limit": null }, { "asp_data_quarter": "2024-Q3", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2025-01-01", "effective_to": "2025-03-31", "file_name": "section 508 version of Jan 2025 ASP Pricing File updated 120925.csv", "file_url": "https://www.cms.gov/files/zip/january-2025-asp-pricing-file-03/11/25-final-file.zip", "notes": null, "payment_limit": 57.603, "quarter": "2025-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2024-Q4", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2025-04-01", "effective_to": "2025-06-30", "file_name": "section 508 version of APR 2025 ASP Pricing File updated 022526.csv", "file_url": "https://www.cms.gov/files/zip/april-2025-asp-pricing-file.zip", "notes": null, "payment_limit": 59.349, "quarter": "2025-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2025-Q1", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2025-07-01", "effective_to": "2025-09-30", "file_name": "section 508 version of JUL 2025 ASP Pricing File updated 022526.csv", "file_url": "https://www.cms.gov/files/zip/july-2025-asp-pricing-file.zip", "notes": null, "payment_limit": 58.562, "quarter": "2025-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2025-Q2", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2025-10-01", "effective_to": "2025-12-31", "file_name": "section 508 version of Oct 2025 ASP Pricing File updated 082026.csv", "file_url": "https://www.cms.gov/files/zip/october-2025-asp-pricing-final-file.zip", "notes": null, "payment_limit": 60.291, "quarter": "2025-Q4", "vaccine_limit": null }, { "asp_data_quarter": "2025-Q3", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2026-01-01", "effective_to": "2026-03-31", "file_name": "section 508 version of January 2026 Medicare Part B Payment Limit File updated 091526.csv", "file_url": "https://www.cms.gov/files/zip/january-2026-medicare-part-b-payment-limit-files.zip", "notes": null, "payment_limit": 59.726, "quarter": "2026-Q1", "vaccine_limit": null }, { "asp_data_quarter": "2025-Q4", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2026-04-01", "effective_to": "2026-06-30", "file_name": "section 508 version of April 2026 Medicare Part B Payment Limit File updated 091526.csv", "file_url": "https://www.cms.gov/files/zip/april-2026-medicare-part-b-payment-limit-files-final-file.zip", "notes": null, "payment_limit": 61.251, "quarter": "2026-Q2", "vaccine_limit": null }, { "asp_data_quarter": "2026-Q1", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2026-07-01", "effective_to": "2026-09-30", "file_name": "section 508 verfsion of July 2026 Medicare Part B Payment Limit File updated 091526.csv", "file_url": "https://www.cms.gov/files/zip/july-2026-medicare-part-b-payment-limit-files.zip", "notes": null, "payment_limit": 60.645, "quarter": "2026-Q3", "vaccine_limit": null }, { "asp_data_quarter": "2026-Q2", "blood_limit": null, "coinsurance_percentage": 20, "dosage": "1 MG", "effective_from": "2026-10-01", "effective_to": "2026-12-31", "file_name": "section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csv", "file_url": "https://www.cms.gov/files/zip/october-2026-medicare-part-b-payment-limit-files-final.zip", "notes": null, "payment_limit": 62.253, "quarter": "2026-Q4", "vaccine_limit": null } ], "quarters_read": 24, "quarters_without_code": [], "short_description": "Inj pembrolizumab", "source_url": "https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files" } ``` ### Payment limits - Capability: `asp-pricing/payment_limits` - Description: Medicare Part B payment allowance limits for drugs, per HCPCS Level II code, from CMS's quarterly ASP pricing file, joined to the ASP NDC-HCPCS crosswalk. Filter by brand or generic name, HCPCS code or NDC, for the newest quarter or any quarter CMS links from 2021-Q1; no filter pages through every code. Each code has its short description, billing unit (dosage), payment limit in USD per billing unit, beneficiary coinsurance percentage, the vaccine and blood AWP-based limits where they apply, CMS's notes, and its NDCs with drug name, labeler, package size and billable units. CPT-coded rows (AMA copyright) are left out. No match is an empty result. - Instructions: For "what does Medicare Part B pay for Keytruda this quarter", "what is the ASP payment limit for J9271", "which HCPCS code bills NDC 00006-3026-02 and how many billing units does it hold" or "what does Medicare pay per unit for Opdivo". The payment limit is Medicare's allowance per HCPCS billing unit, generally 106% of the manufacturer-reported average sales price (ASP), so it is the closest free proxy for a net price of a physician-administered drug. For one code across quarters, use asp-pricing/payment_limit_history; for IRA negotiated prices, negotiated-prices/search; for pharmacy acquisition cost, data-medicaid-gov prices/search (NADAC); for Medicare spending, data-cms-gov drug-spending/search. - Cost: 5 credits per call - Capability file: [Payment limits](https://firecrawl.dev/alexandria/agents/providers/cms-gov/asp-pricing/payment_limits) Accepted options: - `drug` (string): Brand or generic name, matched case-insensitively anywhere in the code's short description (`Inj pembrolizumab`) or in a crosswalk drug name (`Keytruda`): `keytruda`, `pembrolizumab`, `trastuzumab`. Biosimilars are listed under their brand names (`zarxio`), so the generic name finds only the reference product. Example: `Inj pembrolizumab` - `hcpcs` (string): A HCPCS Level II code, a letter and four digits: `J9271`. CPT codes (five digits) are AMA copyright and not served. Example: `J9271` - `include_ndcs` (boolean): List each code's NDCs from the crosswalk. Defaults to true when `drug`, `hcpcs` or `ndc` is given, false otherwise; `ndc_count` is always given. With `ndc`, only the matching NDCs are listed. Example: `false` - `limit` (number): Most codes to return. Example: `10` - `ndc` (string): An NDC-11 as 11 digits (`00006302602`) or hyphenated 5-4-2 (`00006-3026-02`), a hyphenated 10-digit NDC (4-4-2, 5-3-2 or 5-4-1), or an NDC-9 product code (`00006-3026`). A bare 10-digit NDC is ambiguous and rejected. Matches the crosswalk's NDCs. Example: `00006302602` - `offset` (number): Codes to skip; pass `next_offset` for the next page. Example: `0` - `quarter` (string): Quarter the payment limits apply to, `2026-Q4`; defaults to the newest CMS has posted. `quarters_available` lists every quarter CMS links (from 2021-Q1). Pattern: ^[0-9]{4}-[Qq][1-4]$. Example: `2026-Q4` Response schema example: ```json { "asp_data_quarter": "2026-Q2", "crosswalk_file_name": "section 508 version of October 2026 ASP NDC-HCPCS Crosswalk 091126.csv", "crosswalk_file_url": "https://www.cms.gov/files/zip/october-2026-ndc-hcpcs-crosswalk-final.zip", "effective_from": "2026-10-01", "effective_to": "2026-12-31", "license": { "attribution": "Source: Centers for Medicare & Medicaid Services (CMS), Medicare Part B Drug Average Sales Price (ASP) payment allowance limits and ASP NDC-HCPCS crosswalk. CPT codes are omitted. Use does not imply CMS endorsement.", "name": "Public domain (U.S. Government work)", "url": "https://www.cms.gov/about-cms/web-policies-important-links/about-website/link-to-us" }, "next_offset": null, "offset": 0, "payment_file_name": "section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csv", "payment_file_url": "https://www.cms.gov/files/zip/october-2026-medicare-part-b-payment-limit-files-final.zip", "quarter": "2026-Q4", "quarters_available": [ "2026-Q4", "2026-Q3", "2026-Q2", "2026-Q1", "2025-Q4", "2025-Q3", "2025-Q2", "2025-Q1", "2024-Q4", "2024-Q3", "2024-Q2", "2024-Q1", "2023-Q4", "2023-Q3", "2023-Q2", "2023-Q1", "2022-Q4", "2022-Q3", "2022-Q2", "2022-Q1", "2021-Q4", "2021-Q3", "2021-Q2", "2021-Q1" ], "results": [ { "blood_awp_percentage": null, "blood_limit": null, "clotting_factor": false, "coinsurance_percentage": 20, "dosage": "1 MG", "hcpcs_code": "J9271", "ndc_count": 2, "ndcs": [ { "billable_units_per_ndc": 100, "billable_units_per_package": 100, "drug_name": "Keytruda", "labeler": "Merck Sharp & Dohme LLC", "ndc": "00006302602", "package_quantity": 1, "package_size": 4, "product_id": "00006-3026-02" }, { "billable_units_per_ndc": 200, "billable_units_per_package": 100, "drug_name": "Keytruda", "labeler": "Merck Sharp & Dohme LLC", "ndc": "00006302604", "package_quantity": 2, "package_size": 4, "product_id": "00006-3026-04" } ], "notes": null, "payment_limit": 62.253, "short_description": "Inj pembrolizumab", "vaccine_awp_percentage": null, "vaccine_limit": null }, { "blood_awp_percentage": null, "blood_limit": null, "clotting_factor": false, "coinsurance_percentage": 20, "dosage": "1 MG", "hcpcs_code": "J9277", "ndc_count": 2, "ndcs": [ { "billable_units_per_ndc": 395, "billable_units_per_package": 395, "drug_name": "Keytruda Qlex", "labeler": "Merck Sharp & Dohme LLC", "ndc": "00006308301", "package_quantity": 1, "package_size": 2.4, "product_id": "00006-3083-01" }, { "billable_units_per_ndc": 790, "billable_units_per_package": 790, "drug_name": "Keytruda Qlex", "labeler": "Merck Sharp & Dohme LLC", "ndc": "00006508301", "package_quantity": 1, "package_size": 4.8, "product_id": "00006-5083-01" } ], "notes": null, "payment_limit": 32.307, "short_description": "Pembrolizumab 1mg berahyalur", "vaccine_awp_percentage": null, "vaccine_limit": null } ], "source_url": "https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files", "total_count": 2 } ```