> ## Documentation Index
> Fetch the complete documentation index at: https://docs.docaroo.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Get procedure likelihood scores

> 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.




## OpenAPI

````yaml openapi.yml post /procedures/likelihood
openapi: 3.1.1
info:
  title: Care Navigation Data API
  version: 1.0.0
  description: >
    # Care Navigation Data API


    The **Care Navigation Data API** provides pricing transparency and provider
    capability data to support informed care navigation, contracting & comliance
    decisions. 

    Our data platform delivers monthly-refreshed contracted rates and procedure
    likelihood scores.



    ## Key Features


    🏥 **In-Network Pricing** – Access contracted rates for healthcare providers
    across multiple billing codes and insurance plans, mined from Terabytes of
    MRF data  

    📊 **Procedure Likelihood** – Get confidence scores indicating provider
    capability for specific medical services & procedures  

    ⚡ **Latest Data** – Monthly-refreshed data with 99.9% uptime SLA



    ## Getting Started


    1. **Contact us** at support@docaroo.com to request API access and receive
    your sandbox API key

    2. **Authenticate** by including your API key in the `X-API-Key` header with
    every request

    3. **Test** using our interactive documentation below or make your first API
    call


    ### Quick Example


    ```bash

    curl -X POST
    "https://care-navigation-gateway-ccg16t89.wl.gateway.dev/pricing/in-network?key=your-api-key-here"
    \
      -H "Content-Type: application/json" \
      -d '{
        "npis": ["1234567890"],
        "planId": "940360524",
        "conditionCode": "99214",
        "codeType": "CPT"
      }'
    ```


    ---
servers:
  - url: https://care-navigation-gateway-ccg16t89.wl.gateway.dev
    description: API Gateway (deployed)
  - url: https://sandbox.api.docaroo.com/v1
    description: Sandbox environment for testing and development
  - url: https://api.docaroo.com/v1
    description: Production environment (coming soon)
security:
  - apiKeyAuth: []
tags:
  - name: Pricing
    description: In-network contracted rate lookup and pricing transparency
  - name: Procedure Likelihood
    description: Provider capability assessment and procedure likelihood scoring
paths:
  /procedures/likelihood:
    post:
      tags:
        - Procedure Likelihood
      summary: Get procedure likelihood scores
      description: >
        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.
      operationId: getProcedureLikelihood
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/ProcedureLikelihoodRequest'
            examples:
              singleProvider:
                summary: Single provider assessment
                description: Evaluate one provider's likelihood for a procedure or service.
                value:
                  npis:
                    - '1487648176'
                  conditionCode: '99214'
                  codeType: CPT
              multipleProviders:
                summary: Provider comparison
                description: Compare procedure likelihood across multiple providers
                value:
                  npis:
                    - '1487648176'
                    - '1043566623'
                    - '1972767655'
                  conditionCode: '99214'
                  codeType: CPT
      responses:
        '200':
          $ref: '#/components/responses/ProcedureLikelihoodSuccess'
        '400':
          $ref: '#/components/responses/BadRequest'
        '401':
          $ref: '#/components/responses/Unauthorized'
        '403':
          $ref: '#/components/responses/Forbidden'
        '413':
          $ref: '#/components/responses/PayloadTooLarge'
        '422':
          $ref: '#/components/responses/UnprocessableEntity'
        '429':
          $ref: '#/components/responses/TooManyRequests'
        '500':
          $ref: '#/components/responses/InternalServerError'
components:
  schemas:
    ProcedureLikelihoodRequest:
      type: object
      required:
        - npis
        - conditionCode
      properties:
        npis:
          type: array
          minItems: 1
          maxItems: 50
          description: List of National Provider Identifiers (NPIs) to assess
          items:
            type: string
            pattern: ^[0-9]{10}$
            description: 10-digit National Provider Identifier
          example:
            - '1487648176'
        conditionCode:
          type: string
          description: Medical billing code to evaluate likelihood for
          example: '81416'
        codeType:
          $ref: '#/components/schemas/CodeType'
    CodeType:
      type: string
      enum:
        - CPT
        - NDC
        - HCPCS
        - RC
        - ICD
        - MS-DRG
        - R-DRG
        - S-DRG
        - APS-DRG
        - AP-DRG
        - APR-DRG
        - APC
        - LOCAL
        - EAPG
        - HIPPS
        - CDT
        - CSTM-ALL
      default: CPT
      description: |
        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
      example: CPT
    ProcedureLikelihoodResponse:
      type: object
      required:
        - data
        - meta
      properties:
        data:
          type: object
          description: Likelihood data organized by NPI
          additionalProperties:
            $ref: '#/components/schemas/ProcedureLikelihood'
        meta:
          $ref: '#/components/schemas/LikelihoodResponseMeta'
    ErrorResponse:
      type: object
      required:
        - type
        - title
        - status
        - detail
      properties:
        type:
          type: string
          format: uri
          description: URI reference identifying the problem type
          example: https://docs.docaroo.com/errors/bad-request
        title:
          type: string
          description: Short, human-readable summary of the problem
          example: Bad Request
        status:
          type: integer
          format: int32
          description: HTTP status code
          example: 400
        detail:
          type: string
          description: Human-readable explanation specific to this occurrence
          example: The planId parameter is required but was not provided.
        instance:
          type: string
          format: uri
          description: URI reference identifying the specific occurrence
          example: /pricing/in-network
        requestId:
          type: string
          description: Unique request identifier for debugging
          example: req_error123
        timestamp:
          type: string
          format: date-time
          description: When the error occurred
          example: '2024-01-15T14:30:00Z'
    ValidationErrorResponse:
      type: object
      required:
        - errors
      properties:
        errors:
          type: array
          items:
            type: object
            required:
              - field
              - message
            properties:
              field:
                type: string
                description: The field that caused the validation error
              message:
                type: string
                description: A human-readable message explaining the validation error
    ProcedureLikelihood:
      type: object
      required:
        - code
        - codeType
        - likelihood
      properties:
        code:
          type: string
          description: The billing code that was evaluated
          example: '81416'
        codeType:
          $ref: '#/components/schemas/CodeType'
        likelihood:
          type: number
          format: float
          minimum: 0
          maximum: 1
          description: Likelihood score from 0.0 (unlikely) to 1.0 (highly likely)
          example: 0.87
    LikelihoodResponseMeta:
      type: object
      required:
        - requestId
        - timestamp
        - processingTimeMs
        - outOfNetworkRecordsCount
      properties:
        requestId:
          type: string
          description: Unique identifier for this request
          example: req_xyz789abc123
        timestamp:
          type: string
          format: date-time
          description: When this response was generated
          example: '2024-01-15T14:30:00Z'
        processingTimeMs:
          type: integer
          description: Processing time in milliseconds
          example: 156
        outOfNetworkRecordsCount:
          type: integer
          description: Total number of out-of-network records found
          example: 68
  responses:
    ProcedureLikelihoodSuccess:
      description: Successful likelihood assessment
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ProcedureLikelihoodResponse'
          examples:
            highLikelihood:
              summary: High likelihood provider
              description: Provider with high confidence score for the procedure
              value:
                data:
                  '1487648176':
                    code: '99214'
                    codeType: CPT
                    likelihood: 0.9
                meta:
                  requestId: req_bb354ef268be
                  timestamp: '2025-06-15T23:22:22.395111Z'
                  processingTimeMs: 731
                  outOfNetworkRecordsCount: 68
    BadRequest:
      description: Bad Request - Invalid request parameters or plan not found
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            invalidNPI:
              summary: Invalid NPI format
              value:
                title: Bad Request
                status: 400
                detail: NPI '123456789' is invalid. NPIs must be exactly 10 digits.
                instance: /pricing/in-network
                requestId: req_error123
                timestamp: '2024-01-15T14:30:00Z'
            planNotFound:
              summary: Plan not found
              value:
                title: Bad Request
                status: 400
                detail: Plan ID '881570490' not found in our database.
                instance: /pricing/in-network
                requestId: req_error456
                timestamp: '2024-01-15T14:30:00Z'
    Unauthorized:
      description: Unauthorized - Missing or invalid API key
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            missingApiKey:
              summary: Missing API key
              value:
                title: Unauthorized
                status: 401
                detail: API key is required. Include X-API-Key header in your request.
                instance: /pricing/in-network
                requestId: req_error456
                timestamp: '2024-01-15T14:30:00Z'
    Forbidden:
      description: Forbidden - Insufficient permissions
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            insufficientPermissions:
              summary: Insufficient permissions
              value:
                title: Forbidden
                status: 403
                detail: >-
                  Your API key does not have permission to access pricing data.
                  Upgrade your plan or contact support.
                instance: /pricing/in-network
                requestId: req_error789
                timestamp: '2024-01-15T14:30:00Z'
    PayloadTooLarge:
      description: Payload Too Large - Too many NPIs in request
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            tooManyNPIs:
              summary: Too many NPIs
              value:
                title: Payload Too Large
                status: 413
                detail: >-
                  Request contains 55 NPIs. Maximum allowed is 50 NPIs per
                  request.
                instance: /pricing/in-network
                requestId: req_error101
                timestamp: '2024-01-15T14:30:00Z'
    UnprocessableEntity:
      description: Unprocessable Entity - Validation error
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ValidationErrorResponse'
          examples:
            validationError:
              summary: Validation error
              value:
                title: Unprocessable Entity
                status: 422
                detail: One or more validation errors occurred.
                instance: /pricing/in-network
                requestId: req_error500
                timestamp: '2024-01-15T14:30:00Z'
    TooManyRequests:
      description: Too Many Requests - Rate limit exceeded
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            rateLimitExceeded:
              summary: Rate limit exceeded
              value:
                title: Too Many Requests
                status: 429
                detail: Rate limit exceeded.
                instance: /pricing/in-network
                requestId: req_error303
                timestamp: '2024-01-15T14:30:00Z'
    InternalServerError:
      description: Internal Server Error - Unexpected server error
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/ErrorResponse'
          examples:
            serverError:
              summary: Internal server error
              value:
                title: Internal Server Error
                status: 500
                detail: An unexpected error occurred. Our team has been notified.
                instance: /pricing/in-network
                requestId: req_error404
                timestamp: '2024-01-15T14:30:00Z'
  securitySchemes:
    apiKeyAuth:
      type: apiKey
      in: header
      name: X-API-Key
      description: >
        Your API key for authentication. Include this header in all requests.


        **Note**: When using the API Gateway
        (care-navigation-gateway-ccg16t89.wl.gateway.dev), 

        use query parameter authentication instead: ?key=YOUR_API_KEY


        Get your API key by reaching out to support@docaroo.com.

````