{"reporting_entity_name": "GQO_PPO","reporting_entity_type": "GQO_PPO","last_updated_on": "2026-10-07","version": "1.0.0","out_of_network":[{"name":"Emergency Dept Visit","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"9928325","description":"Emergency Dept Visit","allowed_amounts":[{"tin":{"type":"ein","value":"273208969"},"service_code":[],"billing_class":"institutional","payments":[{"allowed_amount":516.70,"providers":[{"billed_charge":1129.00,"npi":[1528028396]}]}]}]},{"name":"Radiologic examination, chest; 2 views","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"7104626","description":"Radiologic examination, chest; 2 views","allowed_amounts":[{"tin":{"type":"ein","value":"541147892"},"service_code":["23"],"billing_class":"professional","payments":[{"allowed_amount":12.31,"providers":[{"billed_charge":39.00,"npi":[1801056833]}]}]}]}]}