{"reporting_entity_name": "GHP_HMO","reporting_entity_type": "GHP_HMO","last_updated_on": "2026-10-07","version": "1.0.0","out_of_network":[{"name":"Ambulance Service Basic Life Support\/Emergency","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0429SH","description":"Ambulance Service Basic Life Support\/Emergency","allowed_amounts":[{"tin":{"type":"ein","value":"237413323"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":437.74,"providers":[{"billed_charge":700.00,"npi":[1609199744]}]}]}]},{"name":"Ground Mileage, Per Statute Mile","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A0425SH","description":"Ground Mileage, Per Statute Mile","allowed_amounts":[{"tin":{"type":"ein","value":"237413323"},"service_code":["41"],"billing_class":"professional","payments":[{"allowed_amount":102.63,"providers":[{"billed_charge":242.00,"npi":[1609199744]}]}]}]}]}