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health.medicare-provider

Retrieve Medicare utilization and payment data by provider using NPI or last name and state. Get beneficiary counts, services, charges, and payment amounts.

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.
Behavior2/5

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

No annotations are provided, so the description carries full burden. It mentions the dataset is annual, implying not real-time, but does not explicitly state read-only behavior, auth requirements, or other behavioral traits. The description does not go beyond the obvious data retrieval nature.

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

Conciseness4/5

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

The description is concise and front-loaded with the core purpose. However, it could be slightly restructured for better readability (e.g., listing fields and query methods in separate sentences).

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?

The description lists the fields returned but does not mention pagination (limit/offset) or error scenarios. With no output schema, more detail on the response structure would be beneficial. It is adequate but not fully complete.

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?

The description adds value by explaining query patterns (by npi or lastName+state), which is not fully covered by the schema descriptions (which only describe npi and lastName individually). However, it does not cover limit and offset parameters. Given the schema description coverage is 40%, the description partially compensates.

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

Purpose5/5

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

The description clearly states it returns Medicare utilization and payment data per provider, lists the data fields (beneficiary counts, charges, payments), and specifies query methods (by NPI or last name+state). It also distinguishes itself from the sibling 'health.open-payments' by noting the pairing.

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

Usage Guidelines4/5

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

The description gives explicit query patterns: by NPI or lastName+state. It also mentions pairing with health.open-payments. However, it lacks explicit guidance on when to use this tool versus other health-related siblings (e.g., health.hospital-lookup, health.provider-profile), which are available in the sibling list.

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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