{"reporting_entity_name":"Key Benefit Administrators, Inc.","reporting_entity_type":"Third-Party Administrator","last_updated_on":"2023-03-01","version":"1.0.0","provider_references":[{"provider_group_id":"840611484","provider_groups":[{"tin":{"type":"ein","value":"840611484"},"npi":["1598747651"]}]},{"provider_group_id":"431039532","provider_groups":[{"tin":{"type":"ein","value":"431039532"},"npi":["1609812445"]}]},{"provider_group_id":"840743432","provider_groups":[{"tin":{"type":"ein","value":"840743432"},"npi":["1225791007"]}]},{"provider_group_id":"204768243","provider_groups":[{"tin":{"type":"ein","value":"204768243"},"npi":["1720527781"]}]},{"provider_group_id":"756000439","provider_groups":[{"tin":{"type":"ein","value":"756000439"},"npi":["1992753222"]}]},{"provider_group_id":"741619182","provider_groups":[{"tin":{"type":"ein","value":"741619182"},"npi":["1346622610"]}]},{"provider_group_id":"841477988","provider_groups":[{"tin":{"type":"ein","value":"841477988"},"npi":["1053481382","1417900200"]}]},{"provider_group_id":"751286819","provider_groups":[{"tin":{"type":"ein","value":"751286819"},"npi":["1710060348"]}]},{"provider_group_id":"271385885","provider_groups":[{"tin":{"type":"ein","value":"271385885"},"npi":["1598764821"]}]},{"provider_group_id":"751362336","provider_groups":[{"tin":{"type":"ein","value":"751362336"},"npi":["1316155443"]}]},{"provider_group_id":"352526373","provider_groups":[{"tin":{"type":"ein","value":"352526373"},"npi":["1407086705","1912999152"]}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"CDM LABS CHGS EFF 8/1/16","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82728","description":"assay of ferritin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CDM LABS CHGS EFF 8/1/16","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84156","description":"assay of protein urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"80053","description":"comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"80061","description":"lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"81003","description":"urinalysis auto w/o scope","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.03,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82043","description":"ur albumin quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.51,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82310","description":"assay of calcium","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"85025","description":"complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.01,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"85652","description":"rbc sed rate automated","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"CORONAVIRUS TEST","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87426","description":"sarscov coronavirus ag ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["204768243"]}]},{"negotiation_arrangement":"ffs","name":"FASTING BLOOD GLUCOSE/PHY","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"83036","description":"hemoglobin glycosylated a1c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.11,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"HOSP HI TECH IMAGING SERV","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"74177","description":"ct abd & pelv w/contrast","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.64,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"36415","description":"routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.00,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"80053","description":"comprehen metabolic panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82105","description":"alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.54,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84443","description":"assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.60,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93306","description":"tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.36,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.36,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93312","description":"echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.44,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.56,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82105","description":"alpha-fetoprotein serum","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.54,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82306","description":"vitamin d 25 hydroxy","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.94,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82340","description":"assay of calcium in urine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.53,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82380","description":"assay of carotene","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.51,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82390","description":"assay of ceruloplasmin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.41,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82962","description":"glucose blood test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.26,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"83550","description":"iron binding test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"83970","description":"assay of parathormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.51,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84153","description":"assay of psa total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.96,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84166","description":"protein e-phoresis/urine/csf","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.25,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84446","description":"assay of vitamin e","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84466","description":"assay of transferrin","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84590","description":"assay of vitamin a","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.47,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"86038","description":"antinuclear antibodies","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"86225","description":"dna antibody native","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"86235","description":"nuclear antigen antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.64,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"86304","description":"immunoassay tumor ca 125","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.14,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"88304","description":"tissue exam by pathologist","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.90,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["741619182"]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99000","description":"specimen handling office-lab","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]}]},{"negotiation_arrangement":"ffs","name":"OP HOSP CLINIC VISIT","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99211","description":"off/op est may x req phy/qhp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.90,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]}]},{"negotiation_arrangement":"ffs","name":"PAP SMEAR","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"88175","description":"cytopath c/v auto fluid redo","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.09,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PPACA ANEMIA LABS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"83540","description":"assay of iron","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"PPACA BLOOD DRAW/VENIPUNC","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"36415","description":"routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.00,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.00,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PPACA BLOOD DRAW/VENIPUNC","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"36416","description":"capillary blood draw","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]}]},{"negotiation_arrangement":"ffs","name":"PPACA HEPATITIS C","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"86803","description":"hepatitis c ab test","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.55,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PPACA HPV","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87624","description":"hpv high-risk types","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PPACA HYPOTHYROIDISM","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"84443","description":"assay thyroid stim hormone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.60,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"PPACA STD/HEPATITIS B","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87389","description":"hiv-1 ag w/hiv-1&-2 ab ag ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"PPACA STD/HEPATITIS B","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87491","description":"chlmyd trach dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PPACA STD/HEPATITIS B","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87591","description":"n.gonorrhoeae dna amp prob","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99202","description":"office o/p new sf 15-29 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["204768243"]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99213","description":"office o/p est low 20-29 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.09,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99214","description":"office o/p est mod 30-39 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.70,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432","841477988"]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"99396","description":"prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.89,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840743432"]}]},{"negotiation_arrangement":"ffs","name":"PrEP","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"80074","description":"acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.18,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"PrEP","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"82570","description":"assay of urine creatinine","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["431039532"]}]},{"negotiation_arrangement":"ffs","name":"PrEP","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"87522","description":"hepatitis c revrs trnscrpj","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.15,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["840611484"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"74246","description":"x-ray xm upr gi trc 2cntrst","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.16,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["751286819"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"76705","description":"echo exam of abdomen","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.89,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["841477988"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"76882","description":"us lmtd jt/fcl evl nvasc xtr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.63,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["271385885"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"92134","description":"cptr ophth dx img post segmt","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["751362336"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"92235","description":"fluorescein angrph uni/bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["751362336"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93306","description":"tte w/doppler complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.36,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.36,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93312","description":"echo transesophageal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.44,"expiration_date":"9999-12-31","billing_class":"institutional"}],"provider_references":["756000439"]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.56,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93320","description":"doppler echo exam heart","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.58,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2023","billing_code":"93325","description":"doppler color flow add-on","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.30,"expiration_date":"9999-12-31","billing_class":"professional"}],"provider_references":["352526373"]}]}]}