Medicare Physician and Practitioner Services and Payments by Provider (CMS)

cmsdata/physician-services

Rows of CMS Medicare physician and practitioner utilisation and payments data: for each provider (NPI), procedure code (HCPCS) and place of service, the number of beneficiaries and services and the average submitted charge, Medicare allowed amount and Medicare payment. Filter by state, NPI or procedure code and page with offset. Procedure code descriptions are not included, only the codes. Values arrive as strings. Reads the single yearly release the tool is pinned to; the release year is not in the response. Centers for Medicare and Medicaid Services data as served by Omnial, not an official CMS product.

activeper callv1

Price

$0.0026 per call

You pay the price shown. If a call turns out to cost more than its quote, you pay the actual price, capped at twice the quote. No monthly minimum. Top-ups start at $5.

Data source

Centers for Medicare & Medicaid Services

Data from the Centers for Medicare & Medicaid Services (CMS), U.S. Department of Health and Human Services; a US federal government work (17 USC 105). Served by Eden Engine; not an official CMS product.

Use it

Five steps: search, inspect, learn, run, settle. No per-tool setup; your agent reaches this tool through the meta-tools it already has.

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agent

// 1. search: find the tool
omnial_search({ query: "what you need" })

// 2. inspect: price and input schema
omnial_inspect({ tool: "cmsdata/physician-services" })

// 3. learn: read the usage guide at runtime
omnial_learn({ tool: "cmsdata/physician-services" })

// 4. run: price the exact call first, then run it
omnial_execute({ tool: "cmsdata/physician-services", input: { /* see input_schema */ }, dry_run: true })
omnial_execute({ tool: "cmsdata/physician-services", input: { /* ... */ } })

// 5. settle: the call is charged when it finishes, nothing to do

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Pricing

Every charge this tool can incur.

Charge	Price
Per call	$0.0026

Updated: Oct 20, 2026

Input and output schemas

Input schema

input_schema.json

{
  "type": "object",
  "required": [
    "size"
  ],
  "properties": {
    "npi": {
      "type": "string",
      "pattern": "^[0-9]{10}$",
      "description": "Ten-digit National Provider Identifier of one provider."
    },
    "size": {
      "type": "integer",
      "maximum": 200,
      "minimum": 1,
      "description": "How many rows to return, 1 to 200."
    },
    "state": {
      "type": "string",
      "pattern": "^[A-Z]{2}$",
      "description": "Two-letter state abbreviation of the provider's practice address, for example NY."
    },
    "offset": {
      "type": "integer",
      "minimum": 0,
      "description": "Rows to skip, for paging. Leave out for the first page."
    },
    "hcpcs_code": {
      "type": "string",
      "pattern": "^[A-Z0-9]{5}$",
      "description": "Five-character HCPCS or CPT procedure code, for example 99221."
    }
  },
  "additionalProperties": false
}

Output schema

output_schema.json

{
  "type": "object",
  "required": [
    "results"
  ],
  "properties": {
    "results": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "HCPCS_Cd": {
            "type": "string",
            "description": "Procedure code."
          },
          "Tot_Benes": {
            "type": "string",
            "description": "Distinct beneficiaries."
          },
          "Tot_Srvcs": {
            "type": "string",
            "description": "Services performed."
          },
          "Rndrng_NPI": {
            "type": "string",
            "description": "National Provider Identifier."
          },
          "Place_Of_Srvc": {
            "type": "string",
            "description": "F facility, O office."
          },
          "Avg_Sbmtd_Chrg": {
            "type": "string",
            "description": "Average submitted charge, dollars."
          },
          "HCPCS_Drug_Ind": {
            "type": "string"
          },
          "Rndrng_Prvdr_MI": {
            "type": "string"
          },
          "Rndrng_Prvdr_St1": {
            "type": "string"
          },
          "Rndrng_Prvdr_St2": {
            "type": "string"
          },
          "Avg_Mdcr_Pymt_Amt": {
            "type": "string",
            "description": "Average Medicare payment, dollars."
          },
          "Rndrng_Prvdr_City": {
            "type": "string"
          },
          "Rndrng_Prvdr_RUCA": {
            "type": "string"
          },
          "Rndrng_Prvdr_Type": {
            "type": "string",
            "description": "Provider specialty."
          },
          "Rndrng_Prvdr_Zip5": {
            "type": "string"
          },
          "Avg_Mdcr_Alowd_Amt": {
            "type": "string",
            "description": "Average allowed amount, dollars."
          },
          "Avg_Mdcr_Stdzd_Amt": {
            "type": "string"
          },
          "Rndrng_Prvdr_Cntry": {
            "type": "string"
          },
          "Tot_Bene_Day_Srvcs": {
            "type": "string"
          },
          "Rndrng_Prvdr_Ent_Cd": {
            "type": "string",
            "description": "I individual, O organization."
          },
          "Rndrng_Prvdr_Crdntls": {
            "type": "string",
            "description": "Credentials, for example MD."
          },
          "Rndrng_Prvdr_RUCA_Desc": {
            "type": "string"
          },
          "Rndrng_Prvdr_First_Name": {
            "type": "string"
          },
          "Rndrng_Prvdr_State_FIPS": {
            "type": "string"
          },
          "Rndrng_Prvdr_State_Abrvtn": {
            "type": "string"
          },
          "Rndrng_Prvdr_Last_Org_Name": {
            "type": "string",
            "description": "Provider's last name, or the organization name."
          },
          "Rndrng_Prvdr_Mdcr_Prtcptg_Ind": {
            "type": "string"
          }
        },
        "additionalProperties": true
      },
      "description": "Matching rows, in CMS's order. Empty when nothing matches. Every value is a string."
    }
  },
  "additionalProperties": false
}