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Pricing & Credits

Outcome-based pricing drawn from a prepaid credit balance: you pay for the physician's review, priced by what the review delivered. Your patient is never charged by Appendix.

Need a different pricing structure? Email hello@appendix.com with a description of your use case and expected monthly volume, and we'll work out pricing that fits.

Volume Pricing

Contact us at hello@appendix.com for flexible volume pricing based on your use case.

Self-Serve Pricing

$45
per complete physician review

The physician reviewed the case and established care — a prescription, clinical advice, or a lab or imaging order.

$8
per incomplete physician review

The physician reviewed the case but was unable to provide a prescription or advice or otherwise establish care.

One fee per review — no per-submission or per-prescription charges. Nothing is charged until a physician completes the review; a request the patient never consents to, or that is canceled before review, costs nothing. Sandbox (test key) submissions are always free.

What counts as a complete review?

A complete review generally means one or more prescriptions were issued. But use cases vary: some deployments use Appendix for second opinions, where the physician's advice is the deliverable. Appendix can also order labs or imaging for some use cases — those are complete reviews too. In short: if the physician established care and delivered a clinical outcome, the review is complete.

We'll review your use case with you before production deployment, so we're aligned on the expected workflow — and on what your costs will look like — before your first real patient.

What counts as an incomplete review?

An incomplete review means a human physician reviewed the case but was unable to provide a prescription or advice or otherwise establish care — for example, an incomplete submission, a request inappropriate for telehealth, or something outside the scope of Appendix services.

Incomplete reviews should be rare in a production deployment: your AI should filter out inappropriate or incomplete submissions before they reach Appendix. The $8 fee exists to incentivize exactly that — it covers the physician's time without making a screening failure free.

What Appendix provides

  • Physician review by a licensed, board-certified physician.
  • E-prescriptions to any pharmacy in the U.S.
  • Lab orders.
  • Imaging orders.

Appendix serves adults, and children 6 months or older.

We do not currently provide prescriptions for controlled substances or GLP-1s.

Prepaid credits with auto-refill

You pre-purchase a credit balance. Each completed review deducts from it. When the balance drops below your threshold, auto-refill tops it up from the card on file. A key with no funded balance can't submit — a natural abuse throttle.

  • Set your auto-refill threshold and top-up amount in the dashboard.
  • Credits are non-refundable once consumed.
  • Sandbox (test key) submissions are always free.

Passing cost through

Most developers fold the cost into their own subscription or charge the end user a flat fee per request.