{"reporting_entity_name":"Key Benefit Administrators, Inc.","reporting_entity_type":"Third-Party Administrator","last_updated_on":"2026-08-01","version":"2.0.0","provider_references":[{"provider_group_id":431039532,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"431039532","business_name":"QUEST DIAGNOSTIC                   "},"npi":[1609812445]}]},{"provider_group_id":205633472,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"205633472","business_name":"CHER LLC                           "},"npi":[1760693493]}]},{"provider_group_id":840743432,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"840743432","business_name":"CLINICA CAMPESINA                  "},"npi":[1922898105]}]},{"provider_group_id":756000439,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"756000439","business_name":"TARRANT COUNTY HOSP DISTRICT       "},"npi":[1992753222]}]},{"provider_group_id":840611484,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"840611484","business_name":"LABCORP DALLAS CYTO HISTO          "},"npi":[1265418669]}]},{"provider_group_id":320359358,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"320359358","business_name":"TEXAS CENTER FOR UROLOGY           "},"npi":[1801859376]}]},{"provider_group_id":751362336,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"751362336","business_name":"TEXAS RETINA ASSOCIATES            "},"npi":[1316155443]}]},{"provider_group_id":352526373,"network_name":["PCM                           ","MULTIPLAN                     "],"provider_groups":[{"tin":{"type":"ein","value":"352526373","business_name":"ACCLAIM PHYSICIANS GROUP INC       "},"npi":[1871943993,1154504496]}]},{"provider_group_id":741841413,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"741841413","business_name":"MEMORIAL CITY CARDIOLOGY ASS       "},"npi":[1790938538]}]},{"provider_group_id":741941710,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"741941710","business_name":"HOUSTON CARDIOVASCULAR ASSOCIATES L"},"npi":[1689929150]}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","description":"ur albumin quantitative","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[431039532]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","description":"complete cbc w/auto diff wbc","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[431039532]}]},{"negotiation_arrangement":"ffs","name":"CONT MAT/RX RADIOLOGY","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9967","description":"locm 300-399mg/ml iodine,1ml","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[205633472]}]},{"negotiation_arrangement":"ffs","name":"FASTING BLOOD GLUCOSE/PHY","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","description":"hemoglobin glycosylated a1c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840743432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HI TECH IMAGING SERVICES","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","description":"ct thorax dx c+","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[205633472]}]},{"negotiation_arrangement":"ffs","name":"HI TECH IMAGING SERVICES","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","description":"ct abdomen w/o & w/dye","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.60,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[205633472]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840611484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[431039532]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","description":"lipid panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","description":"acute hepatitis panel","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","description":"hemoglobin glycosylated a1c","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840743432]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86704","description":"hep b core antibody total","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","description":"hep b surface antibody","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","description":"hiv-1 ag w/hiv-1&-2 ab ag ia","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.30,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","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","setting":"outpatient","service_code":["11"]}],"provider_references":[840611484]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","description":"assay of free testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840611484]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","description":"assay of total testosterone","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840611484]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","description":"dna/rna amplified probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87481","description":"candida dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","description":"strep a dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87653","description":"strep b dna amp probe","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","description":"detect agent nos dna amp","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"LABS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","description":"fundus photography w/i&r","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[751362336]}]},{"negotiation_arrangement":"ffs","name":"OP HOSP CLINIC VISIT","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","description":"office o/p est sf 10 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]}]},{"negotiation_arrangement":"ffs","name":"PPACA BLOOD DRAW/VENIPUNC","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36415","description":"routine venipuncture","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[756000439]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840611484]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[431039532]}]},{"negotiation_arrangement":"ffs","name":"PPACA BLOOD DRAW/VENIPUNC","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","description":"collj capillary blood spec","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840743432]}]},{"negotiation_arrangement":"ffs","name":"PPACA STD/HEPATITIS B","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","description":"detect agnt mult dna ampli","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","description":"office o/p est low 20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.70,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[352526373]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[840743432]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","description":"office o/p est mod 30 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[741841413]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","description":"prev visit est age 40-64","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[352526373]}]},{"negotiation_arrangement":"ffs","name":"PrEP","billing_code_type":"CPT","billing_code_type_version":"2026","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","setting":"outpatient","service_code":["11"]}],"provider_references":[431039532]}]},{"negotiation_arrangement":"ffs","name":"TELEPHONE/INTERNET CONSUL","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","description":"phone e/m phys/qhp 11-20 min","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.10,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[352526373]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","description":"us transrectal","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[320359358]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","description":"electrocardiogram complete","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[741841413]}]},{"negotiation_arrangement":"ffs","name":"XRAYS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","description":"extracranial bilat study","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[741941710]}]}]}