{"uid":"cap_qrg3sizOrPO_eUnsFtzCp","slug":"2s-io-medicare-provider-utilization-payments-lookup-291062d3","name":"2s.io Medicare Provider Utilization & Payments Lookup","description":"Medicare utilization + payments by provider (CMS 'Physician & Other Practitioners - by Provider' annual dataset). Look up by npi, or filter by lastName (exact last/organization name) + state. Each row: provider NPI, name, credentials, entity type, full address, provider type/specialty, Medicare participation, beneficiary counts, total services, submitted charges, Medicare allowed/payment amounts, plus beneficiary demographic + chronic-condition aggregates — CMS's documented column names (Rndrng_NPI, Tot_Srvcs, Tot_Mdcr_Pymt_Amt, etc). Complements /api/health/open-payments (industry payments to the same NPIs). KYC, healthcare-fraud research, and provider due diligence. For a provider 360 (identity + industry payments + this) by NPI in one call, see /api/health/provider-profile. Public-domain federal data.","url":"https://2s.io/api/health/medicare-provider","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method","queryParams"],"properties":{"type":{"const":"http"},"method":{"const":"GET"},"queryParams":{"properties":{"npi":{"type":"string","description":"10-digit provider NPI."},"limit":{"type":"integer","default":10,"maximum":100,"minimum":1},"state":{"type":"string","description":"2-letter state code."},"offset":{"type":"integer","default":0,"minimum":0},"lastName":{"type":"string","description":"Exact last name / organization name (case-sensitive as published by CMS)."}}}}}}},"responseSchema":null,"example":{"request":{"input":{"type":"http","method":"GET","queryParams":{"limit":10,"state":"CA","offset":0,"lastName":"Smith"}}},"response":{"data":{"ok":true,"items":[{"HCPCS_Cd":"93010","Tot_Benes":"265","Tot_Srvcs":"286","HCPCS_Desc":"Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only","Rndrng_NPI":"1003856931","Place_Of_Srvc":"F","Avg_Sbmtd_Chrg":"54","HCPCS_Drug_Ind":"N","Rndrng_Prvdr_MI":"S","Rndrng_Prvdr_St1":"1000 Trancas Street","Rndrng_Prvdr_St2":"","Avg_Mdcr_Pymt_Amt":"7.0901048951","Rndrng_Prvdr_City":"Napa","Rndrng_Prvdr_RUCA":"1","Rndrng_Prvdr_Type":"Emergency Medicine","Rndrng_Prvdr_Zip5":"94558","Avg_Mdcr_Alowd_Amt":"9.1145804196","Avg_Mdcr_Stdzd_Amt":"5.9895104895","Rndrng_Prvdr_Cntry":"US","Tot_Bene_Day_Srvcs":"280","Rndrng_Prvdr_Ent_Cd":"I","Rndrng_Prvdr_Crdntls":"DO","Rndrng_Prvdr_RUCA_Desc":"Metropolitan area core: primary flow within an urbanized area of 50,000 and greater","Rndrng_Prvdr_First_Name":"Timothy","Rndrng_Prvdr_State_FIPS":"06","Rndrng_Prvdr_State_Abrvtn":"CA","Rndrng_Prvdr_Last_Org_Name":"Smith","Rndrng_Prvdr_Mdcr_Prtcptg_Ind":"Y"},{"HCPCS_Cd":"99283","Tot_Benes":"12","Tot_Srvcs":"13","HCPCS_Desc":"Emergency department visit with low level of medical decision making","Rndrng_NPI":"1003856931","Place_Of_Srvc":"F","Avg_Sbmtd_Chrg":"380","HCPCS_Drug_Ind":"N","Rndrng_Prvdr_MI":"S","Rndrng_Prvdr_St1":"1000 Trancas Street","Rndrng_Prvdr_St2":"","Avg_Mdcr_Pymt_Amt":"57.627692308","Rndrng_Prvdr_City":"Napa","Rndrng_Prvdr_RUCA":"1","Rndrng_Prvdr_Type":"Emergency Medicine","Rndrng_Prvdr_Zip5":"94558","Avg_Mdcr_Alowd_Amt":"76.81","Avg_Mdcr_Stdzd_Amt":"50.831538462","Rndrng_Prvdr_Cntry":"US","Tot_Bene_Day_Srvcs":"13","Rndrng_Prvdr_Ent_Cd":"I","Rndrng_Prvdr_Crdntls":"DO","Rndrng_Prvdr_RUCA_Desc":"Metropolitan area core: primary flow within an urbanized area of 50,000 and 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greater","Rndrng_Prvdr_First_Name":"Chelsey","Rndrng_Prvdr_State_FIPS":"06","Rndrng_Prvdr_State_Abrvtn":"CA","Rndrng_Prvdr_Last_Org_Name":"Smith","Rndrng_Prvdr_Mdcr_Prtcptg_Ind":"Y"}],"total":null,"source":{"url":"https://data.cms.gov/","license":"Public domain (US government records)","provider":"CMS Medicare Physician & Other Practitioners"}},"meta":{"cost":{"usd":0.00288,"tier":0},"caller":"x402","version":null,"endpoint":"health.medicare-provider","settlement":{"txHash":"0x14d1de003b09e6db5ae69db419abd7d0de70d93fd1ad63e7b5cf21d34e72f47e","network":"eip155:8453","success":true}}}},"exampleRequest":{"limit":10,"state":"CA","offset":0,"lastName":"Smith"},"tags":["x402"],"displayCostAmount":"0.00288","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"settled","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.00288/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.0072","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.0072","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_VlPX31B7yubmTbt13RAC2","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.0072","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Look up CMS Medicare utilization and payment data for a specific provider by NPI or filter by last name and state, returning billing statistics, beneficiary demographics, and chronic-condition aggregates.","exampleAgentPrompt":"Pull up the CMS Medicare utilization and payment data for NPI 1234567890 — I want to see their total services, Medicare payment amounts, and beneficiary demographics from the latest annual dataset.","exampleUseCases":null,"resultDescription":"Returns one or more provider records from the CMS Physician & Other Practitioners dataset, each including: provider NPI, name, credentials, entity type, full address, specialty/provider type, Medicare participation flag, beneficiary counts, total services rendered, submitted charges, Medicare allowed and payment amounts, and beneficiary demographic and chronic-condition aggregate fields using CMS's official column names (e.g. Rndrng_NPI, Tot_Srvcs, Tot_Mdcr_Pymt_Amt).","failureModes":["NPI not found in CMS dataset — returns empty result set","lastName filter is case-sensitive and must match CMS-published name exactly — typos yield no results","State code must be a valid 2-letter USPS abbreviation — invalid codes return no results","Pagination offset beyond available records returns empty array","Payment failure or invalid x402 credentials returns 402 error"],"whenToPreferThis":"Use this endpoint when you need structured CMS Medicare billing and utilization data for a specific provider or set of providers — particularly for KYC, healthcare fraud research, provider due diligence, or enriching provider profiles with public payment data. Prefer this over general web search when you need authoritative federal data with standardized CMS column names and demographic/chronic-condition aggregates.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T00:57:33.505Z","isFirstParty":false}