Evaluate the likelihood that healthcare providers (NPIs) perform specific medical procedures or services.

Our data models analyze historical claims data, provider specialties & associations with medicare data.
to generate confidence scores from **0.0** (unlikely) to **1.0** (highly likely).

### Scoring Methodology
- **Claims History Analysis** – Past procedure volume and frequency from MRF data and medicare data.
- **Provider Specialization** – Medical specialty alignment.


Get procedure likelihood scores

Medical billing code standard:
- **CPT**: Current Procedural Terminology
- **NDC**: National Drug Code
- **HCPCS**: Healthcare Common Procedure Coding System
- **ICD**: International Classification of Diseases
- **DRG**: Diagnosis Related Group (various types)
- **APC**: Ambulatory Payment Classification
- **CDT**: Current Dental Terminology


Likelihood score from 0.0 (unlikely) to 1.0 (highly likely)

Compare procedure likelihood across multiple providers

Evaluate one provider's likelihood for a procedure or service.

apiKeyQuery

Provider with high confidence score for the procedure

Unauthorized - Missing or invalid API key

Payload Too Large - Too many NPIs in request

Internal Server Error - Unexpected server error

Care Navigation Data API

Pricing transparency and provider capability data to support informed care navigation, contracting & compliance decisions

Care Navigation Data API endpoints and documentation

API Reference

Retrieve contracted rates for healthcare providers (NPIs) for specific billing codes and insurance plans. 

This endpoint supports bulk lookups for up to **10 NPIs** per request, enabling efficient pricing 
discovery across multiple providers simultaneously.

### Supported Rate Types
- **Fee-for-Service (FFS)** – Per-procedure contracted rates
- **Capitated** – Monthly per-member rates *(coming soon)*
- **Bundled** – Episode-based payment models *(coming soon)*

### Use Cases
- Care navigation and provider comparison
- Patient cost estimation and transparency
- Network adequacy analysis
- Provider directory integration
- Contracting and compliance analysis


Overview

API Documentation

API Endpoints

Get procedure likelihood scores

Scoring Methodology

Authorizations

Body

Response