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health.medicare-provider

Retrieve Medicare utilization and payment data for providers by NPI or last name and state. Includes beneficiary counts, services, charges, and payments.

Instructions

Medicare utilization + payments by provider (CMS annual dataset): beneficiary counts, total services, submitted charges, Medicare payment amounts per NPI. By npi, or lastName + state. Pairs with health.open-payments.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
npiNo10-digit provider NPI.
limitNo
stateNo
offsetNo
lastNameNoExact last/organization name as published by CMS.
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries the full burden. It explains the data source (CMS annual dataset) and lists the fields returned. However, it does not disclose data freshness, rate limits, authentication requirements, or whether the operation is read-only (though it is clearly a query). The description is adequate but not rich.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is extremely concise and front-loaded: two sentences that immediately state the tool's purpose, key data, and search options. No fluff or redundant information.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

Given the tool has 5 parameters and no output schema, the description is brief. It does not explain the return format or data shape (e.g., is it an array of objects?), nor does it mention pagination behavior or error handling. For a tool with this complexity, more detail would be beneficial, though the core functionality is clear.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 40% with only npi and lastName having descriptions. The description adds value by clarifying the two primary search modes ('By npi, or lastName + state'), but does not explain limit, offset, or state. State is implied as part of a combo but lacks a standalone description. The description compensates partially for low coverage.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose4/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the tool provides Medicare utilization and payments by provider, listing specific data fields (beneficiary counts, total services, etc.) and lookup methods (by npi or lastName+state). It distinguishes itself from health.open-payments by noting they pair together, but does not differentiate from other sibling health tools like health.provider-profile.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines3/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description implies usage by stating it can be queried by npi or lastName+state and pairs with health.open-payments. However, it does not explicitly state when to use this tool versus alternatives like health.provider-profile, nor does it provide any exclusion criteria or prerequisites.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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