Medicaid Intelligence

Medicaid Drug Utilization

medicaid_drug_utilization

Read-onlyIdempotent

Quarterly state-level Medicaid utilization rows for a drug — prescriptions, units and reimbursement per state and quarter, separated into fee-for-service and managed care. Ask by NAME ("Ozempic") or by an exact 11-digit NDC. Reimbursement is gross before Medicaid rebates and is not manufacturer revenue or net price.

Input Schema

TableJSON Schema

Name	Required	Description
`ndc`	No	Exact 11-digit National Drug Code, hyphenated or not, e.g. "00002-1433-80". Optional — give this OR drug. An NDC narrows to one package size.
`drug`	No	Drug name as it appears on the package, e.g. "Ozempic" or "Humira" — matched against the Medicaid product list, aggregating every package size. A generic ingredient is expanded to its NDCs automatically when Medicaid lists it only under brands.
`year`	No	Calendar year 2020-2026. Defaults to the most recent year with data.
`limit`	No
`state`	No	US state, as a two-letter code ("CA") or a full name ("California") — both are accepted.
`offset`	No
`utilization_type`	No	Restrict to fee-for-service or managed-care records; omit for both.

Output Schema

TableJSON Schema

Name	Required	Description	Default
`total`	Yes
`source`	Yes
`records`	Yes
`returned`	Yes
`interpretation`	Yes

Schema Changelog

Changes observed during successful MCP inspections.

Changed4 schema fields changedAug 12, 2026

changedInput schema / examples

Previous value: -[
-  {
-    "limit": 25,
-    "ndc": "00002143380",
-    "state": "CA",
-    "utilization_type": "Managed Care",
-    "year": 2025
-  }
-]New value: +[
+  {
+    "drug": "Ozempic",
+    "state": "CA",
+    "year": 2026
+  },
+  {
+    "limit": 25,
+    "ndc": "00002143380",
+    "state": "CA",
+    "utilization_type": "Managed Care",
+    "year": 2025
+  }
+]

addedInput schema / properties / drug

Added value: +{
+  "description": "Drug name as it appears on the package, e.g. \"Ozempic\" or \"Humira\" — matched against the Medicaid product list, aggregating every package size. A generic ingredient is expanded to its NDCs automatically when Medicaid lists it only under brands.",
+  "type": "string"
+}

changedInput schema / properties / ndc / description

Previous value: -"Exact 11-digit National Drug Code, hyphenated or not, e.g. \"00002-1433-80\" or \"00002143380\". Resolve a brand or ingredient name to an NDC first with openfda_drug_label or rxnorm."New value: +"Exact 11-digit National Drug Code, hyphenated or not, e.g. \"00002-1433-80\". Optional — give this OR drug. An NDC narrows to one package size."

changedInput schema / required

Previous value: -[
-  "ndc"
-]New value: +[]

First observedAug 3, 2026

TDQS

A4.2/5.0

Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already declare read-only and idempotent behavior. The description adds an important definitional caveat—reimbursement is gross before rebates and is not manufacturer revenue or net price—which goes beyond the structured fields and helps prevent misinterpretation.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is two sentences, front-loaded with the core output definition and followed by essential query instructions and a critical caveat. Every sentence earns its place with no fluff.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

Given the output schema exists, the description doesn't need to detail return values. It effectively covers the main data semantics and the reimbursement interpretation. Minor gaps remain around pagination behavior and handling conflicting inputs, but these are secondary and partially handled by schema and annotations.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

The schema covers 71% of parameters with descriptions. The description reiterates the 'name or NDC' input modes but doesn't explain the undocumented limit and offset parameters, nor does it add new meaning beyond the schema for the other parameters.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly specifies the data returned: quarterly state-level Medicaid utilization rows with prescriptions, units, and reimbursement, separated by fee-for-service and managed care. This level of detail distinguishes it from sibling tools like medicaid_drug_trend or medicaid_drug_state_market.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

It gives clear context for use by explaining how to query (by name or exact NDC) and what data is returned. However, it does not explicitly mention alternative tools or provide when-not-to-use guidance, so it stops short of a 5.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

All Medicaid Intelligence tools Inspect

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