MyMedi-AI

Decode a denial code and structure a redetermination/appeal letter outline with the supporting documentation to attach.

Look up a drug by brand or generic name in openFDA and return its first matching FDA label: brand and generic name, manufacturer, NDCs, route, substance, product type, and the label's indications, warnings, dosage and administration, adverse reactions and drug-interactions sections (null when the label has no such section). Adds an LLM-generated summary, labelled as such: therapeutic class, common uses, alternative therapies and clinical notes. It does not check interactions between drugs — use drug_interactions for that — and makes no prior-authorization, coverage or cost determination. A fai…

Adverse event reports that name drugs together: coReportCount, the number of FAERS reports naming every listed drug; the reactions most often named in them; and for each reaction a proportional reporting ratio (PRR) with a 95% confidence interval against the reports of each drug without the others. A reaction is marked disproportionate when it has at least 3 co-reports and the lower bound exceeds 1 against every drug (null when a comparison cannot be computed). Drugs are matched by the product name as reported: a brand name such as Coumadin is not merged with its generic, warfarin. A name no F…

Look up drug information including label data, adverse events, and related diagnosis codes. Source: openFDA (FDA drug labels and adverse-event reports); related diagnosis codes come from the MyMedi-AI code database.

Normalize a drug name with NIH RxNorm: returns the matching RxNorm concepts (RxCUI, name, synonym, term type) and the primary RxCUI. It does not check interactions — use drug_interactions for drug-drug interaction signals. Source: RxNorm, from the U.S. National Library of Medicine (RxNav API).

Pull the DMEPOS fee schedule for a code and state and explain the rental-vs-purchase and rural-vs-non-rural options.

Look up the CMS DMEPOS fee schedule for a DME/orthotic/prosthetic HCPCS code: rental (RR) vs purchase (NU new / UE used), non-rural vs rural, per state. Give a state for exact rates, or omit for national min–max ranges; filter by modifier to narrow to rental or purchase. Source: the current CMS DMEPOS fee schedule quarter. For professional-service (CPT) payment use code_reimbursement instead.

Specialty snapshot for a US state: how many providers one CMS NPPES registry query matches for the specialty (the query returns at most 200 records, so the figure is a floor, not a provider count), plus an LLM-generated estimate, labelled as such, of demand outlook, likely underserved areas and opportunities. Not a CMS or quality measure. A failed call (model unavailable) is refunded.

Editorial guidance on DMEPOS billing modifiers: the KX/GA/GY/GZ medical-necessity and liability family, RR/NU/UE rental-vs-purchase, capped-rental month markers (KH/KI/KJ), and RT/LT laterality. Pass a HCPCS code to scope guidance to that item's DMEPOS category, or a category directly; add a scenario phrase (e.g., "ABN on file", "bilateral") to surface the relevant modifiers. Original editorial content, not payer policy. PHI-free. Free, no API key required.

Extract the medical codes already present in de-identified text and check each against the MyMedi-AI code database: ICD-10-CM codes whole, dotted or undotted, with their 7th-character extensions (S72.001A, S72001A); HCPCS Level II codes (a letter A–V and four digits), with modifiers attached (E0601RR, E0601-RR) reported as modifiers — a glued suffix only when it is a known DMEPOS modifier; and CPT codes only where a keyword such as CPT or procedure code marks them (Category II and III and PLA codes such as 0001U included), so ZIP codes and other numbers are not read as codes, and a five-digit …

Blank pre-delivery checklist for a HCPCS DMEPOS code: the universal standard written order (SWO) elements (42 CFR 410.38(d)), whether the code is on the current CMS Required Face-to-Face Encounter & Written Order Prior to Delivery List (F2F/WOPD), and whether it is on the current CMS Required Prior Authorization List, on a date of service (default today). Some items are phased in by state: for those, paRequired is null until a state is given. Requirement definitions only — PHI-free, never send patient data. Free, no API key required.

Assemble the blank pre-delivery paperwork checklist for a HCPCS code: SWO elements, F2F/WOPD, and prior authorization.

Map a supplier HCPCS catalog against the current CMS Required Prior Authorization List and Required Face-to-Face Encounter & Written Order Prior to Delivery List on a date of service (default today). Per code: PA requirement and the date it applies from, F2F/WOPD requirement, documentation gates (SWO, UTN-before-claim, F2F/WOPD sequencing), and deterministic denial-risk flags — plus a catalog-level exposure summary. Some items are phased in by state: pass a state for a definitive answer; without one they are reported as required in some states (paRequiredInSomeStates). Unknown or non-HCPCS cod…

Prior-authorization outlook for a procedure code. The approval rate is computed only from your organization's own decided prior authorizations for that code — never from other customers' records — and needs at least 10; an API key or account with no organization has no cohort. With a cohort it returns the approval rate with cohort size and confidence. Without one it returns the verifiable facts instead — CMS Required Prior Authorization List status, category, and published review timeframes — and explicitly reports that no probability was computed (the call is refunded on this path). Never fab…

Check whether a HCPCS code is on the current CMS Required Prior Authorization List (42 CFR 414.234) on a date of service (default today). Returns paRequired flag, category, nationwide-since date, and list version. Some items are phased in by state: for those, paRequired is null until a state is given. Original Medicare FFS scope. Free, no API key required.

Check the status of a prior authorization request tracked in your MyMedi-AI web workspace (by its MyMedi-AI PA id). Returns current status, dates, and expiration info. It does not query payers, and returns not-found (refunded) if the PA was never entered in the web app — for a code's PA requirement use the free pa_required_check.

Look up a provider by NPI in the CMS NPPES registry (name, credential, primary and other taxonomies, practice address, enumeration date) and add an LLM-generated estimate, labelled as such, of specialty demand, network gaps and referral categories for that type of provider. The model is given the provider type — specialty, taxonomy, credential, state, entity type and enumeration date — never the name or NPI. Not a CMS or quality measure. A failed call (unknown NPI, model unavailable) is refunded.

Look up pharmaceutical and device company payments to a physician (Sunshine Act data). Returns total payments, breakdown by type, and top paying companies. Source: CMS Open Payments.

Search the NPI provider directory. Find healthcare providers by name, specialty, or location.

Look up Medicare payment for a code. Returns the national facility and non-facility payment under the current Medicare PFS (CMS RVU × conversion factor) for professional services, plus ranges from the current CMS DMEPOS fee schedule quarter (rental/purchase, min–max across state fees) for DME items like E/K/L codes. Free, no API key required.

Check a draft DME claim's codes and date of service with claims_validate, check prior-authorization and F2F/WOPD list requirements with the free tools, and turn the findings into a prioritized pre-submission fix list.

Search active clinical trials by condition, ICD-10 code, or intervention. Returns trial details including NCT ID, phase, enrollment, and eligibility. Source: ClinicalTrials.gov.