# Metriport Medical API vs Zus Health

> Zus Health scores 56.6 (C) to Metriport Medical's 50.1 (D) for patient record retrieval. Prices, MCP, x402, uptime and agent notes side by side.

- Canonical: https://www.anchorterminal.com/compare/metriport-vs-zus-health
- Markdown: https://www.anchorterminal.com/compare/metriport-vs-zus-health.md (~2,400 tokens)
- Slim: https://www.anchorterminal.com/compare/metriport-vs-zus-health.min.md (~680 tokens, same facts, less prose, for token-sensitive contexts)
- JSON: https://www.anchorterminal.com/compare/metriport-vs-zus-health.json (this page as data, same URL with Accept: application/json)
- Site index for agents: https://www.anchorterminal.com/llms.txt (full text: https://www.anchorterminal.com/llms-full.txt)
- API: https://www.anchorterminal.com/api/v1/index.json
- Updated: 2026-10-14

Zus Health scores 56.6 (C) on agent readiness against Metriport Medical API's 50.1 (D), and leads in 4 of 7 scored categories. Metriport Medical API leads on maintenance & community. Both do patient record retrieval.

- Metriport Medical API: grade D, 50.1/100, rank #833 of 1076. Markdown https://www.anchorterminal.com/tools/metriport.md · JSON https://www.anchorterminal.com/api/v1/tools/metriport.json
- Zus Health: grade C, 56.6/100, rank #669 of 1076. Markdown https://www.anchorterminal.com/tools/zus-health.md · JSON https://www.anchorterminal.com/api/v1/tools/zus-health.json
- Best health record and wellness data APIs for AI agents: https://www.anchorterminal.com/best/health-data/index.md
- All 63 health comparisons: https://www.anchorterminal.com/compare/health-data/index.md

## Which one, for what

### Metriport Medical API (D)

Good for: US care providers and digital health companies that need a patient's network records as FHIR with webhooks.

Ahead on:
- Maintenance & community, 74 against 64

Also in its favour:
- Open source

Watch for: Every API key has full access, including destructive operations, with no scopes

### Zus Health (C)

Good for: US care organisations and digital health builders that want a shared, continuously refreshed patient profile in FHIR with EHR embedding.

Ahead on:
- Reliability, 66 against 45
- Schema & documentation, 77 against 65
- Security & auth, 49 against 41

Watch for: No public prices, and the sandbox is requested through a Google Form


## Score by category

| Category | Weight | Metriport Medical API | Zus Health | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 45 | 66 | Zus Health +21 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 65 | 77 | Zus Health +12 |
| Agent ergonomics | 13% (16.2 this run) | 70 | 67 | Metriport Medical API +3 |
| Security & auth | 14% (17.5 this run) | 41 | 49 | Zus Health +8 |
| Payments & pricing | 10% (12.5 this run) | 5 | 5 | even |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 74 | 64 | Metriport Medical API +10 |
| Transparency & trust | 7% (8.8 this run) | 56 | 59 | Zus Health +3 |
| Negative events | ≤15 | 0 | 0 | |
| **Total** | | **50.1 · D** | **56.6 · C** | |

## Facts side by side

| Fact | Metriport Medical API | Zus Health |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | Metriport Inc. | Zus Health, Inc. |
| Hosted endpoint | no (local only) | no (local only) |
| Transports | HTTP | HTTP |
| Auth | API key | OAuth |
| Pricing | Paid | Paid |
| x402 | no | no |
| Licence | Proprietary hosted service under Metriport's terms of use. The source in metriport/metriport is AGPLv3, with an enterprise directory under its own licence, and the @metriport/api-sdk package on npm is MIT | Proprietary service under the Zus Builder Terms of Service (last updated 11 March 2025), the Developer Sandbox Terms and the Zus Business Associate Addendum |
| Read-only variant documented | no | no |
| llms.txt | yes | yes |
| Last release | 2026-09-28 | 2026-10-14 |
| Terms last updated | 2024-01-01 | 2025-03-11 |
| Privacy policy last updated | 2023-02-21 | 2026-06-24 |
| Customer content may train models | not found in the text | not found in the text |
| Terms restrict automated access | yes | not found in the text |
| Terms restrict benchmarking | yes | not found in the text |
| Terms or service can change without notice | yes | not found in the text |
| Arbitration or class-action waiver | yes | not found in the text |
| Popularity | 793 stars, 28k npm/wk | none |

## Verdicts

**Metriport Medical API.** One network query pulls a patient's records from HIEs, pharmacies and labs and returns deduplicated FHIR, with per-operation rate limits, RFC 7807 errors and AGPLv3 source. Each API key has full access with no scopes, there are no public prices, and the sandbox opens only after Metriport approves the account.

**Zus Health.** FHIR R4 over an aggregated patient profile drawn from CommonWell, Carequality, Surescripts, Quest and ADT networks, with published rate limits, a 99.5 per cent SLA and a dated changelog. Accounts and sandboxes are provisioned by Zus on request, with no public prices, no named security certification and no SDK.

## Before you call either

### Metriport Medical API

1. Check the `errors` array after Start Network Query. It returns 2XX even when some sources fail
2. Wait for `network-query.*` webhooks or poll Get Network Query Status before reading consolidated data, which is cached from the last query
3. Send the resource's `eTag` in `If-Match` on updates to avoid overwriting newer data
4. Keep patient creates under 15 a minute and network queries under 20 a minute per source
5. In sandbox, create patients whose first name matches a pre-defined persona to get example records

### Zus Health

1. Cache the access token for its hour. More than 200 token requests an hour per App Client returns 429
2. Request Patient History at most once per patient per 24 hours, and poll the job status endpoint
3. Use conditional create by identifier so a retried write doesn't duplicate a resource
4. Send `Zus-If-Match` with the resource's ETag on PUT and PATCH
5. Set `_count` up to 500 on searches, since the default page is 10

## Questions

### Which is better for AI agents, Metriport Medical API or Zus Health?

Zus Health scores 56.6 (C) on agent readiness against Metriport Medical API's 50.1 (D), and leads in 4 of 7 scored categories. Metriport Medical API leads on maintenance & community.

### Do Metriport Medical API and Zus Health need an API key?

Metriport Medical API needs an API key. Zus Health uses an OAuth sign-in.

### Can an agent call Metriport Medical API and Zus Health without installing anything?

No hosted endpoint is listed for Metriport Medical API. No hosted endpoint is listed for Zus Health.

### Are Metriport Medical API and Zus Health open source?

Metriport Medical API is open source (Proprietary hosted service under Metriport's terms of use. The source in metriport/metriport is AGPLv3, with an enterprise directory under its own licence, and the @metriport/api-sdk package on npm is MIT). No open-source release is listed for Zus Health.


## For agents

- This comparison as JSON: https://www.anchorterminal.com/compare/metriport-vs-zus-health.json, and with the fewest tokens: https://www.anchorterminal.com/compare/metriport-vs-zus-health.min.md
- Over MCP at https://www.anchorterminal.com/mcp (no key): `compare_tools {"a": "metriport", "b": "zus-health"}`. From a terminal: `anchor compare metriport zus-health`
- Each listing in full: https://www.anchorterminal.com/api/v1/tools/metriport.json and https://www.anchorterminal.com/api/v1/tools/zus-health.json

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