> ## Documentation Index
> Fetch the complete documentation index at: https://docs.penelope.health/llms.txt
> Use this file to discover all available pages before exploring further.

# Data Coverage

Penelope provides comprehensive coverage data from major US health insurers and Medicare:

### Data Sources

* **Insurance Payers**: such as UnitedHealthcare, Cigna, Aetna, Anthem, Humana, Blue Cross Blue Shield of Michigan, Blue Shield of California, CareFirst, Florida Blue...
* **Medicare**: CMS National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and Local Coverage Articles (LCAs)

For a full list of our payers, call the [List Payers](/api-reference/list-payers) endpoint, and [List LOBs](/api-reference/list-lobs) for the lines of business under each payer.

### Coverage Statistics

#### Medical Coding Systems

* **CPT Codes** (Current Procedural Terminology): \~10,000 procedure codes
* **CPT Modifiers**: \~200 procedure modifiers
* **HCPCS Level 2 Codes**: \~6,500 alphanumeric codes for services and supplies
* **HCPCS Modifiers**: \~50 service modifiers
* **ICD-10-CM Codes** (Diagnosis): \~72,000 diagnosis codes with hierarchical structure
* **ICD-10-PCS Codes** (Procedures): \~78,000 inpatient procedure codes

#### Insurance Coverage Data

* **Insurance Payers**: the payers as per our [List Payers](/api-reference/list-payers) endpoint, plus Medicare
* **Lines of Business**: Hundreds of lines of business across commercial, Medicare, Medicaid, and exchange markets
* **Coverage Policies**: Thousands of policies across both medical and pharmacy benefits. Topics we cover include:
  * **Medical benefit**: infusion drugs and biologics, surgical procedures, radiology and advanced imaging, laboratory and genetic testing, and pain management
  * **Pharmacy benefit**: GLP-1 receptor agonists for type 2 diabetes and weight loss, behavioral health such as ADHD medications, and other specialty drugs
* **Pharmacy Formularies**: Drug prior-authorization requirements by plan and formulary
* **Medicare Contractors**: 20+ Medicare Administrative Contractors (MACs) with state jurisdictions

### Update Frequency

* **Medicare data**: Updated quarterly with CMS releases
* **Commercial policies**: Monitored continuously, updated as payers publish revisions
* **Medical codes**: Updated annually (CPT/HCPCS) or as CMS releases updates (ICD-10-CM)


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