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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, not a public API provider. This entry is an honest, gated stub:
- No self-serve developer portal. There is no
developer.surescripts.comyou can sign up for, no free API key, and no public OpenAPI or REST reference. You cannot call Surescripts directly and start sending prescriptions. - Access is certification-gated. To connect directly you must become a Surescripts-certified participant — a conformance process against current NCPDP standards (and a DEA third-party audit for EPCS / controlled substances). Industry reporting describes direct certification as a multi-month-to-multi-year, high-cost effort.
- 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 (NewRx, RxRenewal, RxChange, RxTransfer, RxFill, CancelRx, NewRxRequest, and the ePA transaction set), the NCPDP Real-Time Prescription Benefit (RTPB) standard, NCPDP formulary and benefit files, X12 270/271 (eligibility) and 278 (prior authorization), and the Direct protocol for secure clinical messaging.
Because the transaction surface is not publicly documented, the APIs listed below are honestly modeled from Surescripts' published solution descriptions and the underlying NCPDP/X12 standards. Each is marked endpointsModeled: true; no base URLs, OpenAPI, plans, rate-limit, or FinOps artifacts are asserted because no public, sourced surface exists.
- 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