{"reporting_entity_name":"Key Benefit Administrators, Inc.","reporting_entity_type":"Third-Party Administrator","last_updated_on":"2026-03-01","version":"2.0.0","provider_references":[{"provider_group_id":133757370,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"133757370","business_name":"LABCORP RARITAN                    "},"npi":[1063497451]}]},{"provider_group_id":251854772,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"251854772","business_name":"MS HERSHEY MEDICAL CENTER          "},"npi":[1568435477]}]},{"provider_group_id":230469150,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"230469150","business_name":"CHESTER COUNTY HOSP HC             "},"npi":[1356333579]}]},{"provider_group_id":251857035,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"251857035","business_name":"MSHMC DEPT RADIOLOGY               "},"npi":[1295738664]}]},{"provider_group_id":232743545,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"232743545","business_name":"UNIV OF PENN RAD                   "},"npi":[1942268404]}]},{"provider_group_id":237354899,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"237354899","business_name":"CHESPENN HEALTH SERVICES INC       "},"npi":[1316545502]}]},{"provider_group_id":232380812,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"232380812","business_name":"ST LUKES PHYSICIAN GROUP           "},"npi":[1235193251]}]},{"provider_group_id":232729852,"network_name":["PCM                           "],"provider_groups":[{"tin":{"type":"ein","value":"232729852","business_name":"CLINICAL CARE ASSOCIATES           "},"npi":[1649271180]}]}],"in_network":[{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2026","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","setting":"outpatient","service_code":["11"]}],"provider_references":[133757370]}]},{"negotiation_arrangement":"ffs","name":"CHRONIC DISEASE MANAGEMEN","billing_code_type":"CPT","billing_code_type_version":"2026","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","setting":"outpatient","service_code":["11"]}],"provider_references":[133757370]}]},{"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":9.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[133757370]}]},{"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":12.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[133757370]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL MAMMOGRAMS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","description":"breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[251854772]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[230469150]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[251857035]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[232743545]}]},{"negotiation_arrangement":"ffs","name":"HOSPITAL MAMMOGRAMS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","description":"scr mammo bi incl cad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[251854772]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[230469150]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[251857035]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.20,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[232743545]}]},{"negotiation_arrangement":"ffs","name":"MAMMOGRAMS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","description":"breast tomosynthesis bi","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[251854772]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[230469150]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[251857035]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[232743545]}]},{"negotiation_arrangement":"ffs","name":"MAMMOGRAMS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","description":"scr mammo bi incl cad","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[251854772]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient"}],"provider_references":[230469150]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[251857035]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.20,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["11"]}],"provider_references":[232743545]}]},{"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":3.00,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[133757370]}]},{"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":84.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[237354899]}]},{"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":136.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[232380812]}]},{"negotiation_arrangement":"ffs","name":"PREV PHYS OFFICE VISITS","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","description":"per pm reeval est pat 65+ yr","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"]}],"provider_references":[232729852]}]}]}