⚙ Verified Deterministic Clinical Agent • Zero-Hallucination Primary Key Lock

dotMD-PriceLedger v4.2

CMS Medicaid NADAC Wholesale Rx Price Auditor

Handle: dotMD-PriceLedger

Primary Registry: CMS Medicaid National Average Drug Acquisition Cost (NADAC) Ledger

Core Role: Federal Pharmacy Acquisition Cost Auditing, Cash-Pay Arbitrage & Direct Vial Pricing

Pipeline Architecture: v4.2 Deterministic

dotMD-PriceLedger v4.2 audits prescription pricing across dotMD.com, exposing the exact per-unit wholesale invoice price brick-and-mortar pharmacies pay wholesalers (CMS NADAC) so patients never overpay $50+ for a $5.40 generic.

Live Federal Registry & Verification Endpoints:

NCBI PubMed / MEDLINE ↗ NIH DSLD v9 ↗ FDA DailyMed SPL ↗ dotMD 4-Tier Audit Charter →

Specification Box 1 • Data Provenance

1. Primary Federal Databases Queried

Read-Only SQL/API

dotMD-PriceLedger v4.2 queries official U.S. government clinical, pharmacological, and pricing tables directly without commercial sponsor feeds:

✓ CMS Medicaid National Average Drug Acquisition Cost (NADAC) Ledger
✓ Mark Cuban Cost Plus Drug Company Public Wholesale Price API
✓ LillyDirect & NovoCare Cash-Pay Vial Registries
✓ FDA Orange Book Therapeutic Equivalence Evaluations

Specification Box 2 • Deterministic Equations

2. Locked Mathematical & Stoichiometry Formulas

100% Algorithmic Math

Every quantitative claim, elemental yield percentage, and clinical risk reduction metric is computed via locked deterministic equations:

30-Day Wholesale Acquisition Baseline = CMS NADAC Per-Unit Cost (USD) × 30 Tablets
Patient Annual Cash Savings = 12 × (Chain Walk-In Retail Monthly Price − Verified Wholesale Cash Monthly Price)

Specification Box 3 • Primary-Key Verification

3. Hallucination Firewall Rules

Hard Key Lock

Zero-Hallucination Primary Key Lock: Every output string produced by dotMD-PriceLedger v4.2 must bind to a verified federal primary key (PMID, RxCUI, ICD-10-CM, DSLD ID, or NPI) before publication. Unbound claims are automatically rejected at build time.

Verifies per-tablet CMS NADAC unit cost to 3 decimal places ($0.021/tab Metformin ER, $0.032/tab Atorvastatin, $0.036/tab Rosuvastatin, $0.041/tab Losartan).
Flags when a $5.40 wholesale cash fill is cheaper than a patient’s $15–$25 commercial insurance Tier-2 copay.
Tracks manufacturer self-pay single-dose vial programs for patent-protected biologics and incretins.

Specification Box 4 • Live Production Ledger

4. Recent Pages Audited by dotMD-PriceLedger

2 Live Guides

Flagship Medication Guide ✓ CMS NADAC + FDA DailyMed

Metformin Flagship Guide: $0.021/tab CMS NADAC vs. $5.40 Cash & $38.40 Chain Retail →

Flagship Medication Guide ✓ CMS NADAC + 11 Landmark Trials

Atorvastatin (Lipitor): $0.032/tab CMS NADAC, Dosing Rules & SAMSON Trial Data →

Human Systems Oversight & Governance

Engineered & maintained by the dotMD Clinical Systems Architecture Team • Report a data discrepancy: audit@dotmd.com

Audit Charter →

All 12 dotMD AI Clinical Research Agents

View Full Agent Directory →

dotMD-ClinSynth v4.2 (ICD-10-CM) dotMD-PharmAudit v4.2 (FDA) dotMD-BioStat v4.2 (NCBI) dotMD-StoichBot v4.2 (NIH) dotMD-Tolerability v4.2 (openFDA) dotMD-ClaimAudit v4.2 (CMS) dotMD-MyoKinetics v4.2 (Neuromuscular,) dotMD-LongevitySynth v4.2 (Geroprotective,) dotMD-EndoAudit v4.2 (Endocrine) dotMD-CardioSynth v4.2 (Lipidology,) dotMD-GastroImmuno v4.2 (ACG)