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Full detail: Where this data comes from
Surescripts operates the largest health information network in the United States, connecting prescribers, pharmacies, pharmacy benefit managers (PBMs), health plans, and health systems for e-prescribing, medication history, benefit and eligibility verification, electronic prior authorization, and clinical interoperability. In 2025 the network routed billions of e-prescriptions with 99.998% average uptime.
APIs.json: https://raw.githubusercontent.com/api-evangelist/surescripts/refs/heads/main/apis.yml
Surescripts is a network operator first and an API provider second — but as of 2026 it is genuinely both. Updated 2026-08-15:
- There IS a developer portal now. Surescripts launched docs.surescripts.com — its Developer Portal — with an initial release dated 2026-08-06. It publishes companion guides for E-Prescribing, Eligibility, Formulary, Real-Time Prescription Benefit, Medication History (ambulatory, pharmacies, claims suppliers, populations), Care Coordination, Directory, Connectivity and Record Locator & Exchange. Several sections (Connectivity & Authentication, Network Operations, Error Guidance, Directory, Batch Eligibility, On-Demand Formulary) sit behind a magic-link login; the rest is public and machine-readable as markdown at
<page>.md. - Two HTTP APIs are publicly documented. The Medication History for Populations API is HL7 FHIR R4 —
GET /ext/v1/Communicationreturning a Bundle of Patient, Organization, Practitioner, MedicationRequest, MedicationDispense, Medication, Condition and Communication resources, with_lastUpdated,_include,_revinclude,_page_tokenand_count. The Formulary Download API is four REST endpoints —/formulary/pbms,/formulary/listTypes,/formulary/lists, and a file endpoint — serving NCPDP Formulary & Benefit 3.0 and v60 lists. - Still no OpenAPI, no self-serve sign-up, no published pricing. Nothing parses as OpenAPI/Swagger at any probed path on
surescripts.com,www.surescripts.comordocs.surescripts.com(probed 2026-08-15). There is no free API key and no public sandbox account. - Authentication is mutual TLS, not OAuth. Every documented surface requires a Surescripts-issued client certificate plus a Participant ID header (
x-participant-idon Formulary Download;X-SENDER-UID+X-SENDER-UID-QUALIFIERon the FHIR API). Surescripts runs its own Certificate Authority — a live probe ofcare-coordination.surescripts.netreturns a certificate issued by Surescripts Issuing Certification Authority under Surescripts Root Certification Authority, and resets anonymous connections before any HTTP response. - Access is certification-gated. To connect directly you must become a Surescripts-certified participant — conformance testing against current NCPDP standards, contract approval by the Surescripts Certification Review Board, identity proofing, and a DEA third-party audit for EPCS / controlled substances.
- Most integrators go through middleware. The practical path for most software vendors is to integrate through a Surescripts-certified EHR, pharmacy system, or middleware/clearinghouse partner that already holds certification, rather than certifying directly.
- Standards, not a proprietary REST API. Surescripts transactions ride on published industry standards: NCPDP SCRIPT 2023011 (NewRx, RxRenewal, RxChange, RxTransfer, RxFill, CancelRx, NewRxRequest, and the ePA transaction set), NCPDP RTPB v13, NCPDP Formulary & Benefit 3.0/v60, X12 270/271 (eligibility) and 278 (prior authorization), HL7 FHIR R4, and the Direct Standard for secure clinical messaging.
The two documented HTTP APIs carry real baseURL values sourced from the provider's own guides and examples. The remaining entries below are still honestly modeled from Surescripts' published solution descriptions and the underlying NCPDP/X12 standards, marked endpointsModeled: true. No OpenAPI, plans or FinOps artifacts are asserted, because Surescripts publishes none.
- Healthcare
- E-Prescribing
- Health Information Network
- NCPDP SCRIPT
- Medication History
- Prior Authorization
- Interoperability
- Gated
- Created: 2026-07-04
- Modified: 2026-07-04
Routes electronic prescriptions between prescribers and pharmacies over the NCPDP SCRIPT standard — NewRx, RxRenewal, RxChange, RxTransfer, RxFill, CancelRx, and NewRxRequest — plus Electronic Prescribing for Controlled Substances (EPCS).
Verifies pharmacy benefit eligibility and returns formulary and benefit coverage details, modeled on X12 270/271 exchange and NCPDP formulary and benefit files.
- Human URL: https://surescripts.com/what-we-do
Returns patient-specific, real-time out-of-pocket drug cost, coverage status, and therapeutic alternatives at the point of prescribing, modeled on the NCPDP RTPB standard.
- Human URL: https://surescripts.com/what-we-do
Automates electronic prior authorization (ePA) between prescribers and payers/PBMs using the NCPDP SCRIPT ePA transaction set.
Secure, HIPAA-compliant clinical message exchange (Direct Secure Messaging) for care coordination, transitions of care, and referrals.
- Human URL: https://surescripts.com/what-we-do
Locates where a patient has clinical records across the network and enables retrieval of relevant clinical documents to inform care.
- Human URL: https://surescripts.com/what-we-do
Not publicly published. Surescripts uses negotiated, subscription- and transaction-based pricing that varies by service module, organization size, and volume; for routing and eligibility transactions, pharmacies and PBMs pay a per-transaction fee. Direct certification also carries its own cost and time investment. Terms are provided on request through Surescripts sales and partnership channels.
FN: Kin Lane Email: kin@apievangelist.com